Organization
KDAGENESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN ISABELLE MAE DAVIS (SPEECH/LANGUAGE THERAPIST)
(917) 678-3999
Entity
Organization
Contact information
Practice address
2244 BRONX PARK E APT 5K, BRONX, NY 10467-7517
(917) 678-3999
Mailing address
2244 BRONX PARK E APT 5K, BRONX, NY 10467-7517
(718) 944-4369
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/02/2009
Last updated
08/02/2009
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