Individual
CHRISTINE DIANA FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
10101 95TH AVE UNIT 1E, OZONE PARK, NY 11416-1736
(929) 314-3116
Mailing address
10101 95TH AVE UNIT 1E, OZONE PARK, NY 11416-1736
(929) 314-3116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
007448
NY
101YP2500X
Professional Counselor
37PC00721400
NJ
Other
Enumeration date
10/06/2020
Last updated
10/25/2020
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