Individual
MRS. IMANI LYDIA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(718) 762-7633
(718) 888-8694
Mailing address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(718) 762-7633
(718) 888-8694
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1518420603
NY
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/07/2019
Last updated
10/31/2022
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