Individual
ATHENA AMELIA INNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 HORIZON DR, HUNTINGTON, NY 11743-4436
(631) 396-2300
Mailing address
158 RULAND RD, SELDEN, NY 11784-1840
(631) 681-4953
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P105689
NY
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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