Provider Demographics
NPI:1790190684
Name:VENTURINI, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:VENTURINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:VENTURINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 716
Mailing Address - Street 2:680 OAK TREE ROAD
Mailing Address - City:PALISADES
Mailing Address - State:NY
Mailing Address - Zip Code:10964-0716
Mailing Address - Country:US
Mailing Address - Phone:845-359-8846
Mailing Address - Fax:
Practice Address - Street 1:716 680 OAK TREE ROAD
Practice Address - Street 2:
Practice Address - City:PALISADES
Practice Address - State:NY
Practice Address - Zip Code:10964-0716
Practice Address - Country:US
Practice Address - Phone:845-359-8846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056728-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist