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Organization
KJG LCSW, PC
Active
Organization
KJG LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE YETTA CORDERO LCSW-R (PRESIDENT)
(917) 618-2379
Entity
Organization
Contact information
Practice address
1844 E 12TH ST, BROOKLYN, NY 11229-2702
(917) 618-2379
Mailing address
1844 E 12TH ST, BROOKLYN, NY 11229-2702
(917) 618-2379
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
73079357
NY
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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