Koly J. Guilavogui, CASAC-T
Counselor, Addiction (Substance Use Disorder) in Bronx, NY. Individual provider (NPI-1).
NPI number1013528512
StatusActive
Last updated in NPPESAug 10, 2020
Details
- NPI
- 1013528512
- Entity type
- Individual (NPI-1)
- Name
- Mr. Koly J. Guilavogui
- Credential
- CASAC-T
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 10, 2020
- Certification date
- Aug 10, 2020
- Last updated
- Aug 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 31698-T | NY | Yes |
Practice location
770 E 176th St Ste 315Bronx, NY 10460-4617
Phone 718-583-5150 · Fax 718-228-7648
Mailing address
770 E 176th StBronx, NY 10460-4617
Phone 718-583-5150 · Fax 718-228-7648
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