Individual
NIKITA JANIECE MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 CHAPEL ST STE 901, BROOKLYN, NY 11201-1916
(718) 398-0153
Mailing address
25 CHAPEL ST STE 901, BROOKLYN, NY 11201-1916
(718) 398-0153
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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