Individual
MS. ELEANOR PONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W-R
Contact information
Practice address
795 WISCONSIN AVE, BAY SHORE, NY 11706-2336
(631) 434-2401
Mailing address
1311 PETERS BLVD, BAY SHORE, NY 11706-4801
(631) 647-7896
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
R035920-1
NY
1041S0200X
School Social Worker
Primary
554036941
NY
Other
Enumeration date
10/21/2010
Last updated
10/22/2010
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