Individual
MS. JO ANN DATTILO TRABOULS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW R BCD
Contact information
Practice address
137 BROOME AVE, ATLANTIC BEACH, NY 11509
(516) 371-4118
(516) 371-9423
Mailing address
137 BROOME AVE, ATLANTIC BEACH, NY 11509
(516) 371-4118
(516) 371-9423
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
R043372-1
NY
104100000X
Social Worker
R043372-1
NY
Other
Enumeration date
12/27/2006
Last updated
09/11/2025
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