THERESA DOMENICHELLO, LCSW

Social Worker

Active Individual
NPI: 1427646074

Practice Address

646 MAIN ST STE 206
Port Jeff Sta, NY 11777

Phone: (631) 213-9377

Specialties

Specialty Code Primary License
Social Worker 104100000X Yes 106018 (NY)

Frequently Asked Questions

NPI 1427646074 is the National Provider Identifier for THERESA DOMENICHELLO, LCSW, a Social Worker provider located in Port Jeff Sta, NY. This NPI was enumerated on January 8, 2021.
THERESA DOMENICHELLO, LCSW practices at 646 MAIN ST STE 206, Port Jeff Sta, NY 11777.

Quick Facts

NPI
1427646074
Type
Individual
Enumerated
Jan 8, 2021
Last Updated
Oct 21, 2024

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