Individual
MRS. JENNIFER FASSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
599 BROOKHAVEN AVE, BELLPORT, NY 11713-1699
(631) 730-1742
Mailing address
599 BROOKHAVEN AVE, BELLPORT, NY 11713-1699
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
7433169
NY
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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