| Organization Name: | ANNE L BOFFOLI BENTZEN LCSW PLLC |
| NPI Number: | 1245532639 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANNE L BOFFOLI BENTZEN LCSW PLLC (SOLE MANAGING MEMBER OF PLLC) |
| Mailing Address: | 380 Route 202 Somers |
| State: | NY US |
| Postal Code: | 105893223 |
| Phone Number: | 9146698126 |
| Fax Number: | 9146695165 |
| NPI Enumeration Date: | 11/17/2010 |
| NPI Last Update Date: | 11/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | R048664-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |