| Phoenix Rose Marriage And Family Therapy Pllc | |
|
26 Margaret Dr Roosevelt NY 11575-1535 | |
| (516) 757-3598 | |
| Not Available |
| Full Name | Phoenix Rose Marriage And Family Therapy Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 26 Margaret Dr, Roosevelt, New York |
| Authorized Official Name and Position | Breana D Johnson (OWNER) |
| Authorized Official Contact | 5167573598 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Rose Marriage And Family Therapy Pllc 26 Margaret Dr Roosevelt NY 11575-1535 Ph: (516) 757-3598 | Phoenix Rose Marriage And Family Therapy Pllc 26 Margaret Dr Roosevelt NY 11575-1535 Ph: (516) 757-3598 |
| NPI Number | 1275154627 |
|---|---|
| Provider Enumeration Date | 04/27/2020 |
| Last Update Date | 04/27/2020 |
| Certification Date | 04/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275154627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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