Individual
MS. DESTINY AZIA EDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 OLD COUNTRY RD STE C103N, WESTBURY, NY 11590-5156
(516) 806-6969
Mailing address
1400 OLD COUNTRY RD STE C103N, WESTBURY, NY 11590-5156
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1722720231
NY
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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