Individual
MRS. MARY KOLESAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
240 MASTIC BEACH RD, MASTIC BEACH, NY 11951-1028
(631) 874-1103
Mailing address
240 MASTIC BEACH RD, MASTIC BEACH, NY 11951-1028
(631) 874-1103
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
73074760
NY
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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