| Donna Detura Lcsw P C | |
|
701 Rt 25a Rocky Point NY 11778-8894 | |
| (631) 374-9343 | |
| (631) 849-5915 |
| Full Name | Donna Detura Lcsw P C |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 701 Rt 25a, Rocky Point, New York |
| Authorized Official Name and Position | Donna Detura (THERAPIST) |
| Authorized Official Contact | 6313793436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donna Detura Lcsw P C Po Box 335 Ridge NY 11961-0335 Ph: (631) 379-3436 | Donna Detura Lcsw P C 701 Rt 25a Rocky Point NY 11778-8894 Ph: (631) 374-9343 |
| NPI Number | 1881046209 |
|---|---|
| Provider Enumeration Date | 07/09/2016 |
| Last Update Date | 07/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881046209 | NPI | - | NPPES |
| 04154436 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R0514981 (New York) | Primary |
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