Individual
MRS. SOPHIA KOUTSOUNADIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16216 UNION TPKE, 303, FRESH MEADOWS, NY 11366-1958
(718) 264-7250
Mailing address
16216 UNION TPKE, 303, FRESH MEADOWS, NY 11366-1958
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
Primary
1409879
NY
Other
Enumeration date
06/20/2013
Last updated
10/30/2018
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