Organization
BUILT FOR GROWTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELA BLAIR LCSW (OWNER)
(718) 913-0234
Entity
Organization
Contact information
Practice address
84 FRONT ST STE A, PORT JERVIS, NY 12771-2415
(718) 913-0234
Mailing address
84 FRONT ST STE A, PORT JERVIS, NY 12771-2415
(718) 913-0234
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
757683
—
NY
Enumeration date
12/05/2022
Last updated
12/05/2022
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