Individual
DEMETRICE ANNETTE CRIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
539 RALPH AVE, BROOKLYN, NY 11233-4903
(646) 387-3025
Mailing address
539 RALPH AVE, BROOKLYN, NY 11233-4903
(646) 387-3025
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
63015112
NY
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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