Individual
CASANDRA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 N MAIN ST, SPRING VALLEY, NY 10977-4906
(718) 828-2666
Mailing address
44 N MAIN ST, SPRING VALLEY, NY 10977-4906
(718) 828-2666
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
665903
NY
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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