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Individual

ALTAMEASE MIDDLETON CLAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
14732 JAMAICA AVE, JAMAICA, NY 11435-4042
(718) 526-8400
Mailing address
9201 212TH ST, QUEENS VILLAGE, NY 11428-1117
(646) 238-5765

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
035177-1
NY

Other

Enumeration date
01/03/2007
Last updated
09/29/2010
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