Individual
DIVINE ALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2271 3RD AVE, NEW YORK, NY 10035-2231
(917) 492-0990
Mailing address
2271 3RD AVE, NEW YORK, NY 10035-2231
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CASAC-T-36477
NY
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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