Individual
TIESHEKA BRATHWAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10819 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-1034
(718) 945-2273
Mailing address
10819 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-1034
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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