Individual
CARRIE DAWN NUSSBAUMGRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
402 MANOR RD # B, STATEN ISLAND, NY 10314-2959
(917) 770-0698
Mailing address
402 MANOR RD # B, STATEN ISLAND, NY 10314-2959
(917) 770-0698
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
08923401
NY
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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