Individual
AVIVIT WOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
694 MAGUIRE AVE, STATEN ISLAND, NY 10309-1661
(917) 674-5981
Mailing address
694 MAGUIRE AVE, STATEN ISLAND, NY 10309-1661
(917) 674-5981
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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