Individual
MRS. LIAT KOBAIVANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14905 79TH AVE APT 627, FLUSHING, NY 11367-3869
(347) 987-7472
Mailing address
14905 79TH AVE APT 627, FLUSHING, NY 11367-3869
(347) 987-7472
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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