Individual
EDGAR CORREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
20 COMMUNITY LN, LIBERTY, NY 12754-2851
(845) 292-8770
Mailing address
10 FULTON ST # 1, MONTICELLO, NY 12701-1904
(845) 707-3337
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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