Individual
CAROLYNN LISBETH LORENZO BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
90 ADAMS AVE, HAUPPAUGE, NY 11788-3631
(631) 609-1953
Mailing address
90 ADAMS AVE, HAUPPAUGE, NY 11788-3631
(516) 462-0825
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
113680
NY
Other
Enumeration date
08/01/2024
Last updated
09/21/2024
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