Individual
CRYSTAL NOEL VACCARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 425-9694
Mailing address
80 WOODBURY RD, HAUPPAUGE, NY 11788-4730
(631) 636-1756
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104900
NY
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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