Individual
VIVIAN VANKOOLWIJK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSA
Contact information
Practice address
1 CRAIG B GARIEPY AVE, ISLIP TERRACE, NY 11752-2820
(631) 581-1778
Mailing address
137 SANFORD RD, CENTEREACH, NY 11720-4137
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
077181-1
NY
1041S0200X
School Social Worker
Primary
077181--1
NY
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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