Doctor Name: | MRS. PATRICIA JUNE MOTT-INTERMAGGIO |
NPI Number: | 1013025626 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RLCSW, CASAC |
License Number: | R047194-1 |
Business Practice Address: | 10 Newberry Ln Southampton, NY - 119682824 |
Business Phone Number: | 6312870087 |
Business Fax Number: | 6312870087 |
Mailing Address: | 10 Newberry Ln, SOUTHAMPTON |
State: | NY |
Postal Code: | 119682824 |
Phone Number: | 6312870087 |
Fax Number: | 6312870087 |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R047194-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |