Individual
CERISSA VULTAGGIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
8 W 8TH ST, RONKONKOMA, NY 11779-3819
(347) 535-2504
Mailing address
8 W 8TH ST, RONKONKOMA, NY 11779-3819
(347) 535-2504
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
004991
NY
Other
Enumeration date
05/04/2024
Last updated
05/04/2024
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