Individual
MISS LATESHA DEJEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 MACDOUGAL ST, APT#1, BROOKLYN, NY 11233-2803
(917) 860-3457
Mailing address
240 MACDOUGAL ST, APT#1, BROOKLYN, NY 11233-2803
(917) 860-3457
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
847277141
NY
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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