Individual
AMY LUCILLE FUSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
909 NEW JERSEY AVE SE APT 801, WASHINGTON, DC 20003-5310
(716) 997-1903
Mailing address
909 NEW JERSEY AVE SE APT 801, WASHINGTON, DC 20003-5310
(716) 997-1903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904008371
VA
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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