Individual
JOHANNA CEBALLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
(718) 716-4400
Mailing address
5530 NETHERLAND AVE APT 1C, BRONX, NY 10471-2364
(347) 735-1026
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/25/2023
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