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Individual

MRS. DENALEIGH FORMAN-AHRENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., L.M.F.T.

Contact information

Practice address
107 W MAIN ST, SUITE #2, EAST ISLIP, NY 11730-2337
(631) 666-1615
Mailing address
75 JAY RD, CENTEREACH, NY 11720-2726
(516) 449-6398

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000743-1
NY

Other

Enumeration date
06/13/2013
Last updated
06/13/2013
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