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General NPI Number Information
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NPI Number | 1609329705
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Entity Type | Organization
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Legal Business Name | TINY TRANSFORMATIONS LLC
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 222 N HENRY ST #2
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City | BROOKLYN
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State | NY
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Zip | 11222-3608
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Country | US
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Telephone | 516-721-4174
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Fax |
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Provider Business Mailing Address
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Address Line | 222 N HENRY ST #2
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City | BROOKLYN
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State | NY
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Zip | 11222-3608
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Country | US
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Telephone | 516-721-4174
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DANIELLE MACCOURTNEY
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Credential | MS, OTR/L, ATP
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Telephone | 516-721-4174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 015407
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License Number State | NY
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