Individual
KIAWNA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
445 OAK ST, COPIAGUE, NY 11726-3111
(631) 257-5173
Mailing address
2746 SCHLEIGEL BLVD, AMITYVILLE, NY 11701-1350
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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