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Individual

MISS MILEDYS NOLASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, CASAC-T

Contact information

Practice address
1510 WATERS PL, SUITE 2ND FLOOR, BRONX, NY 10461-2700
(347) 493-8556
Mailing address
1510 WATERS PL, SUITE 2ND FLOOR, BRONX, NY 10461-2700
(347) 493-8556

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101YA0400X
101YA0400X
NY
Enumeration date
07/21/2010
Last updated
07/21/2010
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