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General NPI Number Information
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NPI Number | 1295232486
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Entity Type | Organization
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Legal Business Name | HAB PROJECT LLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PH
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 646-535-0453
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Fax |
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Provider Business Mailing Address
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Address Line | 230 PARK PL APT 5G
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City | BROOKLYN
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State | NY
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Zip | 11238-4331
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Country | US
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Telephone | 713-614-2551
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JUDITH ARIELA HARBOUR
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Credential | LCSW
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Telephone | 713-614-2551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 084296-1
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License Number State | NY
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