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General NPI Number Information
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NPI Number | 1649986993
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Entity Type | Organization
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Legal Business Name | FRESH START MARRIAGE AND FAMILY THERAPY, PLLC
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 15 W 38TH ST STE 820
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City | NEW YORK
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State | NY
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Zip | 10018-5501
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Country | US
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Telephone | 877-777-9711
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Fax | 877-777-9711
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Provider Business Mailing Address
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Address Line | 15 W 38TH ST STE 820
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City | NEW YORK
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State | NY
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Zip | 10018-5501
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Country | US
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Telephone | 877-777-9711
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Fax | 877-777-9711
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AQUANDALLA DAVIS
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Credential |
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Telephone | 347-394-9283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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