Individual
GINA ANN CONDURSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1650 SYCAMORE AVE, SUITE 39, BOHEMIA, NY 11716-1738
(631) 758-8290
Mailing address
1650 SYCAMORE AVE, SUITE 39, BOHEMIA, NY 11716-1738
(631) 758-8290
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
078843-1
NY
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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