Individual
NICOLE T VELAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
81 LAKE AVE FL 2, ROCHESTER, NY 14608-1410
(585) 368-6901
Mailing address
81 LAKE AVE FL 2, ROCHESTER, NY 14608-1410
(585) 368-6901
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29191
NY
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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