Provider Demographics
NPI:1811578743
Name:TRAVAGLIATO, CAMILLE HEATHER
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:HEATHER
Last Name:TRAVAGLIATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 WHITE PLAINS RD STE 232
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5015
Mailing Address - Country:US
Mailing Address - Phone:914-725-5252
Mailing Address - Fax:
Practice Address - Street 1:688 WHITE PLAINS RD STE 232
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5015
Practice Address - Country:US
Practice Address - Phone:914-725-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health