Individual
ALEXANDRA L VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
353 MARTHA AVE, BELLPORT, NY 11713-1524
(631) 286-6703
Mailing address
353 MARTHA AVE, BELLPORT, NY 11713-1524
(631) 286-6703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
076-393-01
NY
1041C0700X
Clinical Social Worker
076393
NY
Other
Enumeration date
03/09/2009
Last updated
05/11/2021
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