Individual
RATSAMEE SUVANNACHAKKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4110 53RD ST APT 3L, WOODSIDE, NY 11377-4273
(929) 485-4886
Mailing address
4110 53RD ST APT 3L, WOODSIDE, NY 11377-4273
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001930
NY
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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