Individual
MRS. CORIEN BOLOGNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT, ATR-BC
Contact information
Practice address
1000 MAIN ST, PORT JEFFERSON, NY 11777-2250
(631) 682-9507
Mailing address
15 PARKRIDGE CIR, PORT JEFFERSON STATION, NY 11776-3418
(631) 682-9507
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
2936702
NY
221700000X
Art Therapist
Primary
001744-01
NY
Other
Enumeration date
07/12/2024
Last updated
08/03/2024
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