Individual
MS. KIM M WISNIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR-BC
Contact information
Practice address
228 LINDA AVE, HAWTHORNE, NY 10532-2050
(914) 773-7428
(914) 747-5647
Mailing address
228 LINDA AVE, HAWTHORNE, NY 10532-2050
(914) 773-7428
(914) 747-5647
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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