Individual
CAROLYN WASIK-PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
19 NORTH ST, MIDDLE ISLAND, NY 11953-1757
(516) 380-0005
Mailing address
19 NORTH ST, MIDDLE ISLAND, NY 11953-1757
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PR046337-1
NY
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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