Provider First Line Business Practice Location Address:
75 HICKS ST
Provider Second Line Business Practice Location Address:
BLANTON PEALE COUNSELING CENTER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-743-3879
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2007