Individual
HEESUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
7405 METROPOLITAN AVE # 2F, MIDDLE VILLAGE, NY 11379-2636
(646) 825-1810
Mailing address
7405 METROPOLITAN AVE # 2F, MIDDLE VILLAGE, NY 11379-2636
(646) 825-1810
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001041-1
NY
Other
Enumeration date
04/02/2008
Last updated
07/16/2020
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