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General NPI Number Information
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NPI Number | 1669263117
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Entity Type | Individual
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Provider Name | KAMREN LATRELL CORRICA MA
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Gender | Male
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1775 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10453-8202
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Country | US
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Telephone | 212-665-1860
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Fax |
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Provider Business Mailing Address
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Address Line | 1652 PARK AVE APT 4D
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City | NEW YORK
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State | NY
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Zip | 10035-4660
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Country | US
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Telephone | 917-701-5379
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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