Individual
TRACIE CASULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ED
Contact information
Practice address
32 COHOES RD, WATERVLIET, NY 12189-1811
(518) 328-0430
Mailing address
32 COHOES RD, WATERVLIET, NY 12189-1811
(518) 328-0430
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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