| Lifespan Wellness Marriage & Family Therapy Pllc | |
|
21333 39th Ave Ste 235 Bayside NY 11361-2174 | |
| (917) 913-6441 | |
| Not Available |
| Full Name | Lifespan Wellness Marriage & Family Therapy Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 21333 39th Ave Ste 235, Bayside, New York |
| Authorized Official Name and Position | Maria Constantinou (DIRECTOR) |
| Authorized Official Contact | 9179136441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Wellness Marriage & Family Therapy Pllc 2608 Bayside Ln Flushing NY 11358-1054 Ph: () - | Lifespan Wellness Marriage & Family Therapy Pllc 21333 39th Ave Ste 235 Bayside NY 11361-2174 Ph: (917) 913-6441 |
| NPI Number | 1982185161 |
|---|---|
| Provider Enumeration Date | 08/24/2018 |
| Last Update Date | 11/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982185161 | NPI | - | NPPES |
| 1730626896 | Other | NY | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 001372 (New York) | Primary |
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