Individual
IBETH PALOMINO DE LA TORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
770 GRAND BLVD, DEER PARK, NY 11729-5750
(631) 392-4357
Mailing address
770 GRAND BLVD, DEER PARK, NY 11729-5750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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