Individual
MS. VIENNA C PHARAON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
280 MADISON AVE, NEW YORK, NY 10016-0801
(917) 289-2302
Mailing address
40 DEMOTT LN, SOMERSET, NJ 08873-1605
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000937
NY
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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