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Individual

IRINA PROFIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
130 FRANKLIN AVE FL 1, HASBROUCK HEIGHTS, NJ 07604-1204
(718) 614-7355
Mailing address
130 FRANKLIN AVE FL 1, HASBROUCK HEIGHTS, NJ 07604-1204
(718) 614-7355

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
057385
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00057385
NY
Enumeration date
11/13/2006
Last updated
10/07/2020
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