Individual
DIANE LOUISE MERCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
240 LONG ISLAND AVE # A, WYANDANCH, NY 11798-3123
(631) 920-8250
(631) 920-8251
Mailing address
34 KING ST, WYANDANCH, NY 11798-4412
(631) 920-8250
(631) 920-8251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18272
NY
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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