Individual
ELISSAVETA G IORDANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
2588 AC POWELL BLVD APT 3M, NEW YORK, NY 10039-2607
(917) 848-7199
Mailing address
2588 AC POWELL BLVD APT 3M, NEW YORK, NY 10039-2607
(917) 848-7199
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
002141-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9046310213
1199
NY
Enumeration date
04/23/2020
Last updated
04/23/2020
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