Individual
STEPHANIE MARIE FORTOUNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 608-5028
Mailing address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 608-5028
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30849
NY
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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