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Individual

EVAN ILLOUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
(718) 245-4887
Mailing address
81 8TH AVE APT 5, BROOKLYN, NY 11215-1507

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
021812
NY

Other

Enumeration date
09/07/2016
Last updated
09/07/2016
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