Individual
ASHLEY ANNE PETITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1050 HALLOCK AVE STE 4, PORT JEFFERSON STATION, NY 11776-1214
(631) 612-8816
Mailing address
PO BOX 75, SHOREHAM, NY 11786-0075
(631) 612-8816
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
093572
NY
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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