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General NPI Number Information
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NPI Number | 1316498256
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Entity Type | Individual
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Provider Name | NATASHA ACEVEDO L.C.A.T
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Gender | Female
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Dates
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Enumeration Date | 10/15/2016
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Last Update Date | 10/15/2016
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Provider Practice Location Address
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Address Line | 6603 BEACH CHANNEL DR
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City | FAR ROCKAWAY
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State | NY
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Zip | 11692-1433
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Country | US
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Telephone | 646-623-6963
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Fax |
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Provider Business Mailing Address
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Address Line | 6028 CATALPA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5160
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 001689-1
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License Number State | NY
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