Individual
TATIANA DZHAKHANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2102 AVENUE Z # 304, BROOKLYN, NY 11235-2812
(347) 521-3250
Mailing address
918 WHITEHALL DR, VALLEY STREAM, NY 11581-2715
(929) 400-5399
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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