| Practical Online Therapy, Llc | |
|
10417 35th Ave Corona NY 11368-1933 | |
| (929) 335-4227 | |
| (929) 376-0029 |
| Full Name | Practical Online Therapy, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10417 35th Ave, Corona, New York |
| Authorized Official Name and Position | Nixaly Leonardo-yakubov (PRESIDENT) |
| Authorized Official Contact | 3478482237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Practical Online Therapy, Llc 10417 35th Ave Corona NY 11368-1933 Ph: (929) 335-4227 | Practical Online Therapy, Llc 10417 35th Ave Corona NY 11368-1933 Ph: (929) 335-4227 |
| NPI Number | 1417615675 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 08/05/2022 |
| Certification Date | 08/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417615675 | NPI | - | NPPES |
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