Individual
EUREKA RAVILUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 E MAIN ST, MIDDLETOWN, NY 10940-4038
(845) 283-0979
Mailing address
210 E MAIN ST, MIDDLETOWN, NY 10940-4038
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
P127356
NY
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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