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General NPI Number Information
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NPI Number | 1629470240
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Entity Type | Individual
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Provider Name | CORYN NADEAU LCAT; ATR-BC
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 460 PARK AVE S
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City | NEW YORK
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State | NY
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Zip | 10016-7315
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Country | US
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Telephone | 860-798-1917
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Fax |
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Provider Business Mailing Address
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Address Line | 101 JEFFERSON AVE
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City | BROOKLYN
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State | NY
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Zip | 11216-1996
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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 | 001368
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License Number State | NY
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