Individual
KHADISHA JOVANSIA ALIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1437 CHANDLER ST, FAR ROCKAWAY, NY 11691-3003
(646) 271-8559
Mailing address
1437 CHANDLER ST, FAR ROCKAWAY, NY 11691-3003
(646) 271-8559
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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