Individual
AUTUMN QUIANA BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
235 MAIN ST STE 520, WHITE PLAINS, NY 10601-2421
(914) 533-4950
Mailing address
1480 POPHAM AVE APT 1J, BRONX, NY 10453-7233
(518) 879-2434
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
103001
NY
1041C0700X
Clinical Social Worker
Primary
096725
NY
Other
Enumeration date
04/25/2018
Last updated
12/26/2023
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