Individual
LANCE TLUSTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-ADVANCED
Contact information
Practice address
2957 DRUM RD, MIDDLEPORT, NY 14105-9732
(585) 735-6912
Mailing address
2957 DRUM RD, MIDDLEPORT, NY 14105-9732
(585) 735-6912
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
34293
NY
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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