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General NPI Number Information
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NPI Number | 1609195999
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Entity Type | Organization
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Legal Business Name | CENTRO ATC
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 5532 NETHERLAND AVE APT 1C
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City | BRONX
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State | NY
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Zip | 10471-2368
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Country | US
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Telephone | 917-703-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 5532 NETHERLAND AVE APT 1C
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City | BRONX
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State | NY
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Zip | 10471-2368
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Country | US
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Telephone | 917-703-8114
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. CLAUDIA N QUIROZ
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Credential | LMHC
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Telephone | 917-703-8114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3588-1
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License Number State | NY
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