Individual
MS. AXIE GHASEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
790 BROADWAY, BROOKLYN, NY 11206-5316
(718) 388-5175
Mailing address
1623 KINGS HWY, BROOKLYN, NY 11229-1209
(718) 375-1200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/27/2016
Last updated
06/14/2016
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