Individual
BRUCE R MARDINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
175 ROUTE 32 NORTH, NEW PALTZ, NY 12561
(845) 255-1400
Mailing address
175 MOUNTAIN RD, ROSENDALE, NY 12472-9652
(845) 658-3467
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
069967-1
NY
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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