Individual
MS. CATHLEEN EVALON DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
646 MAIN ST, PORT JEFFERSON, NY 11777-2235
(631) 828-4135
Mailing address
646 MAIN STREET, PORT JEFFERSON, NY 11777
(631) 828-4135
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0727061
NY
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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