Organization
LIC MARRIAGE AND FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER DISOMMA LICENSED (MARRIAGE AND FAMILY THERAPIST)
(631) 365-9350
Entity
Organization
Contact information
Practice address
3164 21ST ST # 121, LONG ISLAND CITY, NY 11106-4573
(631) 365-9350
Mailing address
3164 21ST ST # 121, LONG ISLAND CITY, NY 11106-4573
(631) 365-9350
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
07/27/2023
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