Healthcare Provider Details

I. General information

NPI: 1710359385
Provider Name (Legal Business Name): JENNYFER ARROYAVE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3726 76TH ST
JACKSON HEIGHTS NY
11372-6508
US

IV. Provider business mailing address

3726 76TH ST
JACKSON HEIGHTS NY
11372-6508
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-0246
  • Fax:
Mailing address:
  • Phone: 718-830-0246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094994-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: