Most Relevant Information
Provider Data
| NPI Number: | 1003646589 |
| Provider Name: | KELSEY DERAFFELE CIVETTA MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/07/2024 |
| Last Updated: | 08/07/2024 |
Provider Practice Location
175 KENT AVE APT 308
BROOKLYN
NY
112494895
Practice Location Phone/Fax
| Phone: | 9142621251 |
| Fax: |
Provider Mailing Location
175 KENT AVE APT 308
BROOKLYN
NY
112494895
Provider Mailing Phone/Fax
| Phone: | 9142621251 |
| Fax: |