Individual
ALEJANDRA CASO ILLANES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
936 BROADWAY, NEW YORK, NY 10010-6013
(212) 879-4900
Mailing address
208 E 88TH ST APT 1C, NEW YORK, NY 10128-3381
(646) 639-4318
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
005681
NY
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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