Individual
MS. ELISSA DUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
6725 188TH ST, FRESH MEADOWS, NY 11365-3767
(718) 454-6460
Mailing address
14751 28TH AVE, FLUSHING, NY 11354-1436
(718) 454-6460
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1125761
NY
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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