Individual
MS. AGNES M. LASETCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
225 MAIN ST., PORT WASHINGTON, NY 11050-3211
(516) 767-1133
(516) 767-3680
Mailing address
225 MAIN ST., PORT WASHINGTON, NY 11050-3211
(516) 767-1133
(516) 767-3680
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P022983-1
NY
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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