Provider First Line Business Practice Location Address:
3950 DOUGLASTON PKWY
Provider Second Line Business Practice Location Address:
COUSELING OFFICE
Provider Business Practice Location Address City Name:
DOUGLASTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11363-1542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-279-0146
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006