Organization
PHOENIX ROSE MARRIAGE AND FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREANA D JOHNSON LMFT (OWNER)
(516) 757-3598
Entity
Organization
Contact information
Practice address
26 MARGARET DR, ROOSEVELT, NY 11575-1535
(516) 757-3598
Mailing address
26 MARGARET DR, ROOSEVELT, NY 11575-1535
(516) 757-3598
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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