Individual
KALOVNA KETSIA EDMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
326 SEA CLIFF ST, ISLIP TERRACE, NY 11752-1109
(631) 309-6831
Mailing address
326 SEA CLIFF ST, ISLIP TERRACE, NY 11752-1109
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
P126365
NY
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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