Individual
BERIZA MILAGROS LUCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADVANCED CASAC
Contact information
Practice address
11630 SUTPHIN BLVD, JAMAICA, NY 11434-1527
(718) 322-2500
(718) 322-1881
Mailing address
5921 CALLOWAY ST APT 5L, CORONA, NY 11368-3839
(917) 749-1917
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19979
NY
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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