Organization
PARENT INFORMATION EXCHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA MOMRELLE (FOUNDER)
(347) 344-0378
Entity
Organization
Contact information
Practice address
1040 OWASCO RD, WEST HEMPSTEAD, NY 11552-4221
(516) 425-1905
Mailing address
1040 OWASCO RD, WEST HEMPSTEAD, NY 11552-4221
(516) 425-1905
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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