Individual
MR. KYLE JAMES DITULLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
64 2ND AVE, ALBANY, NY 12202-1240
(518) 449-5170
(518) 598-0493
Mailing address
64 2ND AVE, ALBANY, NY 12202-1240
(518) 449-5170
(518) 598-0493
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22400
NY
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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