Provider First Line Business Practice Location Address:
C/O INTEGRATIVE COUNSELING SERVICES
Provider Second Line Business Practice Location Address:
10 OAK #3
Provider Business Practice Location Address City Name:
WESTHAMPTON BEACH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-922-2312
Provider Business Practice Location Address Fax Number:
631-288-8576
Provider Enumeration Date:
08/21/2006