Individual
BREANNA FRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4271 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5708
(516) 520-6600
Mailing address
4271 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5708
(516) 520-6600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
098181
NY
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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