Individual
MR. JEAN VERNET SOUFFRANT SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA NCPSYA
Contact information
Practice address
110-17 37TH AVENUE, CORONA, NY 11368
(718) 429-1825
(718) 565-2086
Mailing address
110-17 37TH AVENUE, CORONA, NY 11368
(718) 429-1825
(718) 565-2086
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
003761
NY
102L00000X
Psychoanalyst
Primary
0001361
NY
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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