Lifespan Wellness Marriage & Family Therapy PLLC
Marriage & Family Therapist in Bayside, NY. Organization (NPI-2).
NPI number1982185161
StatusActive
Last updated in NPPESNov 30, 2018
Details
- NPI
- 1982185161
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifespan Wellness Marriage & Family Therapy PLLC
- Organization subpart
- No
- Enumeration date
- Aug 24, 2018
- Last updated
- Nov 30, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 001372 | NY | Yes |
Practice location
21333 39th Ave Ste 235Bayside, NY 11361-2174
Phone 917-913-6441
Mailing address
2608 Bayside LnFlushing, NY 11358-1054
Other practice locations
2391 Bell Blvd Ste 202
Flushing, NY 11360-2019
Flushing, NY 11360-2019
Phone 917-913-6441
Authorized official
Maria Constantinou
Director
9179136441
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