Individual
MS. DEANNA STAVRIS-LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED.
Contact information
Practice address
1597 LAUREL HOLLOW RD, SYOSSET, NY 11791-9636
(516) 692-7985
(516) 692-4845
Mailing address
1597 LAUREL HOLLOW RD, SYOSSET, NY 11791-9636
(516) 692-7985
(516) 692-4845
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19131711
—
NY
Enumeration date
11/17/2011
Last updated
11/17/2011
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