Individual
DEBORAH MARIE CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
177 E 122ND ST, NEW YORK, NY 10035-2906
(212) 360-7116
Mailing address
177 E 122ND ST, NEW YORK, NY 10035-2906
(212) 360-7116
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6620
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6620
—
NY
Enumeration date
04/23/2018
Last updated
04/23/2018
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