Provider First Line Business Practice Location Address:
37-22 82ND ST.
Provider Second Line Business Practice Location Address:
CORONA ELMHURST GUIDANCE CENTER
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-779-1600
Provider Business Practice Location Address Fax Number:
718-803-0895
Provider Enumeration Date:
03/09/2011