Individual
MS. STEPHANIE BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
74 W 124TH ST, NEW YORK, NY 10027-5685
(347) 807-2699
Mailing address
2064 MOHEGAN AVE, BRONX, NY 10460-1760
(347) 807-2699
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
090663
NY
Other
Enumeration date
03/10/2014
Last updated
12/18/2024
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