Individual
COLLEEN ROSE MAIDHOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
445 OAK ST FL 2, COPIAGUE, NY 11726-3111
(631) 561-7277
Mailing address
445 OAK ST FL 2, COPIAGUE, NY 11726-3111
(631) 561-7277
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104064
NY
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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