Individual
MRS. ANGELICA I KHAIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
24302 NORTHERN BLVD, DOUGLASTON, NY 11362-1150
(718) 423-6200
Mailing address
6941 183RD ST, FRESH MEADOWS, NY 11365-3535
(718) 969-4972
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
086491
NY
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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