Individual
GENIA ROLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC TRAINEE
Contact information
Practice address
1688 VICTORY BLVD, BASEMENT, STATEN ISLAND, NY 10314-3547
(718) 447-5700
Mailing address
1688 VICTORY BLVD, BASEMENT, STATEN ISLAND, NY 10314-3547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25666
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25666
CASAC TRAINEE
NY
Enumeration date
09/13/2011
Last updated
09/13/2011
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