Individual
CAROLINE MARGARET IDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
201 DIXON AVE, AMITYVILLE, NY 11701-2832
(516) 263-5983
Mailing address
201 DIXON AVE, AMITYVILLE, NY 11701-2832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
108051
NY
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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