Individual
TAHISHA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 E 102ND ST, BROOKLYN, NY 11236-5034
(347) 418-6468
Mailing address
1217 E 102ND ST, BROOKLYN, NY 11236-5034
(347) 418-6468
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2634480
NY
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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