Individual
DR. AZA MANTASHASHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMHC
Contact information
Practice address
1 STONE PL, BRONXVILLE, NY 10708-3426
(914) 441-7460
Mailing address
214 E 82ND ST APT 5, NEW YORK, NY 10028-2728
(914) 441-7460
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NY
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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