Individual
MS. BRENDA L WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1332 SURF AVENUE, BROOKLYN, NY 11224
(718) 449-4000
(718) 449-5146
Mailing address
1841 25TH RD, ASTORIA, NY 11102-3427
(816) 213-9775
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
077648
NY
1041C0700X
Clinical Social Worker
2005015072
MO
Other
Enumeration date
06/12/2007
Last updated
09/30/2010
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