Organization
LIFESPAN WELLNESS MARRIAGE & FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA CONSTANTINOU LMFT (DIRECTOR)
(917) 913-6441
Entity
Organization
Contact information
Practice address
21333 39TH AVE STE 235, BAYSIDE, NY 11361-2174
(917) 913-6441
Mailing address
2608 BAYSIDE LN, FLUSHING, NY 11358-1054
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001372
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730626896
NPPES
NY
Enumeration date
08/24/2018
Last updated
11/30/2018
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