Individual
MIOSOTTE CABAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CASAC-T, FDC
Contact information
Practice address
11515 SUTPHIN BLVD, JAMAICA, NY 11434-1020
(718) 297-8000
Mailing address
11515 SUTPHIN BLVD, JAMAICA, NY 11434-1020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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