Individual
MARIE CHANTAL LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14736 225TH ST, SPRINGFIELD GARDENS, NY 11413-4101
(646) 221-4771
Mailing address
14736 225TH ST, SPRINGFIELD GARDENS, NY 11413-4101
(646) 221-4771
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
706721
NY
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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