Individual
AI HAYATSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS
Contact information
Practice address
109 N 12TH ST, BROOKLYN, NY 11249-1002
(914) 979-1731
Mailing address
387 E 4TH ST APT 2, BROOKLYN, NY 11218-3921
(917) 287-2768
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
P130046
NY
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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