Individual
MRS. GINA DEFALCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
229 N PINE ST, MASSAPEQUA, NY 11758-2812
(516) 528-5822
Mailing address
229 N PINE ST, MASSAPEQUA, NY 11758-2812
(516) 528-5822
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
073927-1
NY
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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