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Individual

MS. GRACE R DERIGGI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC, LMFT

Contact information

Practice address
55 NESCONSET HWY, SUITE #3, PORT JEFFERSON STATION, NY 11776-2631
(631) 793-6079
Mailing address
55 NESCONSET HWY, SUITE #3, PORT JEFFERSON STATION, NY 11776-2631
(631) 793-6079

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
002472
NY
106H00000X
Marriage & Family Therapist
Primary
000430
NY

Other

Enumeration date
05/14/2007
Last updated
03/17/2011
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