Individual
AMBER LUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 LAFAYETTE ST RM 501, NEW YORK, NY 10013-4116
(613) 252-5016
Mailing address
110 LAFAYETTE ST RM 501, NEW YORK, NY 10013-4116
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
099681
NY
Other
Enumeration date
10/29/2019
Last updated
03/07/2025
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