Individual
CHARMAINE VIVIENNE WITTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 E 53RD ST APT 6D, BROOKLYN, NY 11234-2342
(718) 909-9043
Mailing address
1200 E 53RD ST APT 6D, BROOKLYN, NY 11234-2342
(718) 909-9043
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
1607685221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310778456
EMBLEM HEALTH
NY
Enumeration date
05/28/2022
Last updated
05/28/2022
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