Organization
CREATING CHANGE COACHING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NODEREA JOHN LCSW (SOCIAL WORKER)
(347) 742-5511
Entity
Organization
Contact information
Practice address
3205 HERING AVE, BRONX, NY 10469-5003
(347) 742-5511
Mailing address
3205 HERING AVE, BRONX, NY 10469-5003
(347) 742-5511
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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