Individual
MRS. MATTHEW GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
200 PANTIGO PL, SUITE I, EAST HAMPTON, NY 11937-5920
(631) 329-8430
(631) 329-8291
Mailing address
200 PANTIGO PL, SUITE I, EAST HAMPTON, NY 11937-5920
(631) 329-8430
(631) 329-8291
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
72 049339
NY
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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