| Susan Bouton Csw Pc | |
|
25 Wimbledon Dr Roslyn NY 11576-3084 | |
| (516) 759-9340 | |
| Not Available |
| Full Name | Susan Bouton Csw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 25 Wimbledon Dr, Roslyn, New York |
| Authorized Official Name and Position | Susan Bouton (PRESIDENT) |
| Authorized Official Contact | 5167599340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Bouton Csw Pc 25 Wimbledon Dr Roslyn NY 11576-3084 Ph: (516) 759-9340 | Susan Bouton Csw Pc 25 Wimbledon Dr Roslyn NY 11576-3084 Ph: (516) 759-9340 |
| NPI Number | 1649520677 |
|---|---|
| Provider Enumeration Date | 09/18/2012 |
| Last Update Date | 06/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649520677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R033006-1 (New York) | Primary |
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