Organization
MARY MANTILLA LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY A MANTILLA LCSWR (CLINICIAN)
(845) 549-8223
Entity
Organization
Contact information
Practice address
17 STONEHEDGE DR, POUGHKEEPSIE, NY 12603-6509
(845) 549-8223
Mailing address
17 STONEHEDGE DR, POUGHKEEPSIE, NY 12603-6509
(845) 549-8223
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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