| Name | ANZALONE TINA BETH |
|---|---|
| Address | CHEEKTOWAGANY |
| Profession | LICENSED CLINICAL SOCIAL WORK |
| License No | 041638 |
| Date of Licensure | 09/01/04 (OriginallylicensedasaCertifiedSocialWorkeron09/05/90) |
| Additional Qualification | R -Psychotherapy Privilege |
| Status | REGISTERED |
| Registered through last day of |