Individual
MISS LAURA MARIE WILBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT, ATR-BC
Contact information
Practice address
402 E 156TH ST, BRONX, NY 10455-1232
(646) 224-7152
Mailing address
760 E 160TH ST FL 2, BRONX, NY 10456-7898
(718) 401-5700
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002336-01
NY
Other
Enumeration date
01/19/2024
Last updated
02/12/2024
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