Doctor Name: | MS. SONIA PALACIO-GROTTOLA |
NPI Number: | 1053467464 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | R030451-1 |
Business Practice Address: | 28 Horseshoe Ln Commack, NY - 117255507 |
Business Phone Number: | 6315431443 |
Business Fax Number: | 6318641536 |
Mailing Address: | 28 Horseshoe Ln, COMMACK |
State: | NY |
Postal Code: | 117255507 |
Phone Number: | 6315431443 |
Fax Number: | 6318641536 |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | R030451-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |