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Individual

PRUDENCE SALVATO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CASAC-T

Contact information

Practice address
109 KELVIN AVE, STATEN ISLAND, NY 10306-3743
(347) 831-9333
Mailing address
109 KELVIN AVE, STATEN ISLAND, NY 10306-3743
(347) 831-9333

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
131624228
NY
Enumeration date
05/29/2020
Last updated
05/29/2020
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