Organization
MARIO H IRIGOYEN LCSW - LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO H IRIGOYEN LCSW (SOLE MBR)
(914) 671-3924
Entity
Organization
Contact information
Practice address
61 GRAND AVE, ENGLEWOOD, NJ 07631-3572
(914) 671-3924
(845) 942-1894
Mailing address
76 THIELLS RD, STONY POINT, NY 10980-3420
(914) 671-3924
(845) 942-1894
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC05377600
NJ
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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