Individual
CYNTHIA STUSVICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8500
Mailing address
14202 20TH AVE, FLUSHING, NY 11351-3000
(718) 559-0555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/12/2020
Last updated
04/12/2020
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