Provider First Line Business Practice Location Address:
33-34 80TH ST.
Provider Second Line Business Practice Location Address:
ELMHURST SCHOOL-BASED MENTAL HEALTH CLINIC - ROOM B32
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372-1341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-899-0592
Provider Business Practice Location Address Fax Number:
718-335-9114
Provider Enumeration Date:
05/12/2008