Individual
MS. EDNA TAMAR DEBEER GRUVMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
15 SHOREHAM DR W, DIX HILLS, NY 11746-6580
(631) 553-7284
Mailing address
360 COURT ST APT 21, BROOKLYN, NY 11231-4348
(631) 553-7284
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
000142-01
NY
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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