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Organization
HISPANIC THERAPY SERVICE
Active
Organization
HISPANIC THERAPY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL ERIC BOU L.C.S.W. (PSYCHOTHERAPIST)
(917) 755-2425
Entity
Organization
Contact information
Practice address
26 ROOSEVELT CT, WESTBURY, NY 11590-4135
(917) 755-2425
Mailing address
26 ROOSEVELT CT, WESTBURY, NY 11590-4135
(917) 755-2425
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
081037-1
NY
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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