Individual
CHRISTINA MICCIULLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
402 EAST MAIN STREET, MIDDLETOWN, NY 12940-7656
(845) 343-2499
(845) 394-0168
Mailing address
549 JEFFERSONVILLE N BRANCH RD, NORTH BRANCH, NY 12766-5217
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P13367
NY
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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