Individual
DENEACER MASSOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 BRANDON DR, COVINGTON, GA 30016-3333
(718) 807-5430
Mailing address
8038 211TH ST, QUEENS VILLAGE, NY 11427-1013
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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