Provider Demographics
NPI:1275078248
Name:AZOULAI, SHIRLEY G (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:G
Last Name:AZOULAI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-1919
Mailing Address - Country:US
Mailing Address - Phone:914-715-1591
Mailing Address - Fax:
Practice Address - Street 1:81 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-1919
Practice Address - Country:US
Practice Address - Phone:914-715-1591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087533-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist