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Individual

CASSANDRA ROSE TAVELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
434 CHELSEA DR, ISLIP, NY 11751-2644
(516) 655-4011
Mailing address
11 FARMINGDALE ROAD, ROUTE 109, WEST BABYLON, NY 11704
(631) 669-5355

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
108151
NY

Other

Enumeration date
05/21/2021
Last updated
05/21/2021
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