Individual
ASHLEY CHARLENE MIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
195 BAY 19TH ST, BROOKLYN, NY 11214-4761
(718) 253-1366
Mailing address
195 BAY 19TH ST, BROOKLYN, NY 11214-4761
(718) 253-1366
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/22/2017
Last updated
08/14/2019
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