Individual
MAXINE PERCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
20 FOURTH ST # 1141, LILY DALE, NY 14752-9704
(347) 613-4567
Mailing address
PO BOX 1141, LILY DALE, NY 14752-1141
(347) 712-7362
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001365
NY
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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