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Raegan Distasio
Mental Health Counselor in Syracuse, New York
NPI 1851143473

Raegan Distasio is a Mental Health Counselor based in Fairport, NY and is specialized in Mental Health. Raegan Distasio practices in Syracuse, NY. The NPI Number for Raegan Distasio is 1851143473 and holds a License No. (New York).

The current practice location address for Raegan Distasio is 1045 James St Ste 100, Syracuse, NY and can be reached out via phone at 315-472-4471.

Location: 1045 James St Ste 100, Syracuse, NY, 14450-9514
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851143473
Provider Name
Raegan Distasio
Credential
Provider Entity Type
Individual
Gender
Female
Address
1045 James St Ste 100, Syracuse, NY, 14450-9514
Phone Number
315-472-4471
Fax Number
Provider Enumeration Date
04/05/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
1045 James St Ste 100
City
Syracuse
State
New York
Zip
13203-2758
Phone Number
315-472-4471
Fax Number
person
Provider Business Mailing Address Details
Address
1045 James St Ste 100
City
Syracuse
State
New York
Zip
13203-2758
Phone Number
315-472-4471
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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