Organization
FRESH START RELATIONAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AQUANDALLA DAVIS (LICENSED MARRIAGE AND FAMILY THERAP)
(347) 394-9283
Entity
Organization
Contact information
Practice address
430 PARK AVE, NEW YORK, NY 10022-3505
(646) 598-4575
Mailing address
15511 115TH AVE, JAMAICA, NY 11434-1007
(347) 394-9283
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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