Individual
LIA MINONNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 15TH ST, BROOKLYN, NY 11215-4988
(171) 878-8510
Mailing address
255 15TH ST, BROOKLYN, NY 11215-4988
(734) 657-5046
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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