Individual
LORETTA DELORES MCMANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC 2
Contact information
Practice address
5-11 PFLUG PLACE, VALLEY STREAM, NY 11580
(516) 825-4242
(516) 825-4253
Mailing address
5-11 PFLUG PLACE, VALLEY STREAM, NY 11580
(516) 825-4242
(516) 825-4253
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7336
CASAC
NY
Enumeration date
10/16/2019
Last updated
10/16/2019
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