Individual
BRENDA S ANGELUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4363 MAPLETON RD, LOCKPORT, NY 14094-9652
(716) 210-2017
Mailing address
4363 MAPLETON ROAD, LOCKPORT, NY 14094-9652
(716) 210-2107
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7363757
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16-600-6136
—
NY
Enumeration date
10/17/2011
Last updated
10/17/2011
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