Individual
MARA MENDICINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-G
Contact information
Practice address
100 ROUTE 59, AIRMONT, NY 10901-4927
(845) 369-9701
Mailing address
100 ROUTE 59, AIRMONT, NY 10901-4927
(845) 369-9701
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21917
NY
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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