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Individual

JENNIFER DEFILLIPO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CASAC-T

Contact information

Practice address
263/267 PORT RICHMOND AVE., STATEN ISLAND, NY 10302
(718) 981-8117
(718) 981-9344
Mailing address
1160 RICHMOND RD, STATEN ISLAND, NY 10304-2443

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21190
NY

Other

Enumeration date
01/17/2012
Last updated
01/17/2012
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