Organization
I HEART SOUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMICA NELSON (SOLE PROPRIETOR)
(914) 648-2505
Entity
Organization
Contact information
Practice address
240 UNDERHILL AVE APT 6, YORKTOWN HEIGHTS, NY 10598
(914) 648-2505
Mailing address
240 UNDERHILL AVE APT 6, YORKTOWN HEIGHTS, NY 10598-4525
(914) 648-2505
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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