Individual
SUSANNE CARMELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
29 LAUREL DR, PORT JEFFERSON, NY 11777-1903
(631) 681-9938
Mailing address
29 LAUREL DR, PORT JEFFERSON, NY 11777-1903
(631) 681-9938
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001746-01
NY
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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