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General NPI Number Information
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NPI Number | 1295345148
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Entity Type | Organization
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Legal Business Name | MICHELLE AMY ABRAHAM
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 594 BROADWAY RM 1217
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City | NEW YORK
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State | NY
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Zip | 10012-3257
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Country | US
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Telephone | 917-699-5331
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E 21ST ST APT 9S
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City | NEW YORK
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State | NY
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Zip | 10010-6415
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Country | US
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Telephone | 917-699-5331
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. MICHELLE A ABRAHAM
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Credential | LCSW
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Telephone | 917-699-5331
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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 |
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License Number State |
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