Individual
WINSOME MATTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4011 FOSTER AVE, BROOKLYN, NY 11203-5633
(347) 556-9547
Mailing address
4011 FOSTER AVE, BROOKLYN, NY 11203-5633
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
083515
NY
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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