Individual
CECILIA FANNY GAVIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
79-01 BROADWAY, ROOM A1-25, ELMHURST, NY 11373
(718) 334-2650
(718) 334-2664
Mailing address
79-01 BROADWAY, ROOM A1-25, ELMHURST, NY 11373
(718) 334-2650
(718) 334-2664
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
081782-1
NY
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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