Individual
BROOKE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1461 LAKELAND AVE UNIT 12, BOHEMIA, NY 11716-2174
(631) 732-4794
Mailing address
1461 LAKELAND AVE UNIT 12, BOHEMIA, NY 11716-2174
(631) 732-4794
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
092211
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02173802
—
NY
Enumeration date
05/15/2015
Last updated
05/20/2015
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