Individual
BEAUTIFUL WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 LOST TREE CT, DOVER, DE 19904-7125
(347) 633-4201
Mailing address
18709 LINDEN BLVD, JAMAICA, NY 11412-4025
(347) 633-4201
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
Q3-0011205
DE
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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