| Doctor Name: | MS. CONSTANCE M VITALE |
| NPI Number: | 1093837981 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LMHC |
| License Number: | 002267-1 |
| Business Practice Address: | 57 Rennie St Malone, NY - 129531138 |
| Business Phone Number: | 5184831460 |
| Business Fax Number: | |
| Mailing Address: | 275 County Route 23, MALONE |
| State: | NY |
| Postal Code: | 129534406 |
| Phone Number: | 5184832312 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 02/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 002267-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |