Provider First Line Business Practice Location Address:
150 BAYVIEW AVE
Provider Second Line Business Practice Location Address:
PORT EARLY CHILDHOOD AND FAMILY THERAPY
Provider Business Practice Location Address City Name:
PORT WASHINGTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11050-3620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-405-0810
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/05/2012