Individual
MISS ALICIA BALLESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT, ATR-BC
Contact information
Practice address
315 WYCKOFF AVE, 6TH FLOOR, BROOKLYN, NY 11237-5384
(718) 497-6090
Mailing address
15348 78TH RD, 3RD FLOOR, FLUSHING, NY 11367-3542
(954) 825-6319
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001796-1
NY
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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