Individual
ANGELINA ACEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
579 COURTLANDT AVE, BRONX, NY 10451-5013
(718) 485-2100
Mailing address
701 W 175TH ST APT 3C, NEW YORK, NY 10033-7612
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
472196599
DRIVER LICENSE
NY
Enumeration date
03/24/2021
Last updated
06/15/2022
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