Individual
KATHY AYERS-LANZALOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
155 INDIAN HEAD RD, COMMACK, NY 11725-2212
(631) 543-6200
Mailing address
65 GRASSY POND DR, SMITHTOWN, NY 11787-4027
(631) 543-6200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1278
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2249145
—
NY
Enumeration date
01/29/2010
Last updated
01/29/2010
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