Individual
BREANNA MARIE ECONOMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2290 9TH AVE, RONKONKOMA, NY 11779-6277
(631) 708-6257
Mailing address
2290 9TH AVE, RONKONKOMA, NY 11779-6277
(631) 708-6257
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
P126356
NY
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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