Individual
JOAN DESMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 634-0012
Mailing address
265 EDGEWATER AVE, BAYPORT, NY 11705-2103
(631) 885-0951
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2909
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2909
CASAC CERTIFICATE
NY
Enumeration date
03/21/2017
Last updated
03/21/2017
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