Individual
ANITA MAMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
291 BROADWAY, NEW YORK, NY 10007-1814
(917) 330-1215
Mailing address
291 BROADWAY, NEW YORK, NY 10007
(917) 330-1215
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
079782-1
NY
Other
Enumeration date
04/04/2007
Last updated
05/16/2014
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