Individual
JUWANA TRISVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
624 CLINTON STREET, BROOKLYN, NY 11231
(646) 546-4577
Mailing address
624 CLINTON STREET, BROOKLYN, NY 11231
(646) 546-4577
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NY
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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