Individual
MRS. ELSIE IME NNEBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPECIAL INSTRUCTOR
Contact information
Practice address
20541 100TH AVE, HOLLIS, NY 11423-3438
(917) 239-8969
Mailing address
20541 100TH AVE, HOLLIS, NY 11423-3438
(917) 239-8969
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
513666041
NY
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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