Individual
ALISA COUSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
201 BRYSON AVE, STATEN ISLAND, NY 10314-1922
(917) 816-1929
Mailing address
201 BRYSON AVE, STATEN ISLAND, NY 10314-1922
(917) 816-1929
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
105798
NY
Other
Enumeration date
02/06/2019
Last updated
12/15/2023
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