Individual
MRS. JOAN E ETTINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
64 S HARBOR RD, NORTHPORT, NY 11768-1178
(631) 261-0517
Mailing address
64 S HARBOR RD, NORTHPORT, NY 11768-1178
(631) 261-0517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3855
NY
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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