Individual
KATHLEEN A DURIVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16 EUCLID AVE, DELMAR, NY 12054-1217
(518) 756-5200
(518) 756-1988
Mailing address
2025 ROUTE 9 W, RAVENA, NY 12143
(518) 756-5200
(518) 756-1988
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
R057-057
NY
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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