Individual
HOLLY M GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
5601 16TH AVE, 5TH FLOOR, BROOKLYN, NY 11204-1809
(718) 686-1526
Mailing address
113 SAINT MARKS PL APT 3W, NEW YORK, NY 10009-5128
(646) 202-1431
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001107-1
NY
Other
Enumeration date
07/12/2007
Last updated
07/12/2007
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