Individual
CARLI BRUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 1ST AVE, MASSAPEQUA PARK, NY 11762-1850
(516) 491-7396
Mailing address
301 1ST AVE, MASSAPEQUA PARK, NY 11762-1850
(516) 491-7396
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P114138
NY
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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