Provider Demographics
NPI:1023701463
Name:LEVINSON, ANNIE ROSE (MS, CCLS)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:ROSE
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:MS, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 KETEWOMOKE DR
Mailing Address - Street 2:
Mailing Address - City:HALESITE
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2136
Mailing Address - Country:US
Mailing Address - Phone:631-617-8210
Mailing Address - Fax:
Practice Address - Street 1:33 KETEWOMOKE DR
Practice Address - Street 2:
Practice Address - City:HALESITE
Practice Address - State:NY
Practice Address - Zip Code:11743-2136
Practice Address - Country:US
Practice Address - Phone:631-617-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist