Individual
AJA MILDRED TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2488 GRAND CONCOURSE RM 417, BRONX, NY 10458-5206
(718) 584-7204
Mailing address
2488 GRAND CONCOURSE RM 417, BRONX, NY 10458-5206
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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