Individual
AVIAN LANISE POPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2698 FREDERICK DOUGLASS BLVD APT 6A, NEW YORK, NY 10030-1263
(718) 612-1614
Mailing address
2698 FREDERICK DOUGLASS BLVD APT 6A, NEW YORK, NY 10030-1263
(718) 612-1614
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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