Individual
CHARISSE MICHELLE SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8020 45TH AVE, ELMHURST, NY 11373-3545
(718) 478-2900
(718) 478-3456
Mailing address
6615 THORNTON PL, APT 5E, REGO PARK, NY 11374-5147
(305) 323-6527
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
085101
NY
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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