Basic Information
| Provider Information | |||||||||
| NPI: | 1235434333 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MIGLIORINO | ||||||||
| FirstName: | XIOMARA | ||||||||
| MiddleName: | AMANDA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CASAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 237 W 115TH ST | ||||||||
| Address2: | APT 6A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100262900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3475000017 | ||||||||
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| Practice Location | |||||||||
| Address1: | 340 E 24TH ST | ||||||||
| Address2: | SUITE 311 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100104019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125856221 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2011 | ||||||||
| LastUpdateDate: | 01/20/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 12974 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.