Provider First Line Business Practice Location Address:
200 WILLOUGHBY AVENUE
Provider Second Line Business Practice Location Address:
3RD FLOOR ISC BUILDING - COUNSELING SERVICES
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11205-3802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-687-5654
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2021