Individual
VICTORIA DAMMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
147 MAYFAIR RD, POUGHQUAG, NY 12570-5011
(631) 921-2879
Mailing address
147 MAYFAIR RD, POUGHQUAG, NY 12570-5011
(631) 921-2879
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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