Provider Information for 1548763600
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Ms. JESSICA MARIE DEL GAUDIO LMHC
Sex: Female
NPI: 1548763600
Last Updated: 2023-03-24
Certification Date: 2023-03-24
Certification Date: 2023-03-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1548763600 | ||||||||
| Enumeration Date | 2018-03-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 172 LIBERTY ST NEWBURGH, NY 12550-4912 United States Phone: 845-561-5783 | Fax: | ||||||||
| Primary Practice Address | 172 LIBERTY ST NEWBURGH, NY 12550-4912 United States Phone: 845-561-5783 | Fax: | ||||||||
| Secondary Practice Address(es) | 146 PIKE ST | ||||||||
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