Individual
ANISSA OUDKERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
18 SUSSEX RD, ELMONT, NY 11003-1421
(516) 439-8931
Mailing address
18 SUSSEX RD, ELMONT, NY 11003-1421
(516) 439-8931
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
096167-01
NY
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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