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General NPI Number Information
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NPI Number | 1780106682
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Entity Type | Individual
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Provider Name | JUDITH MELISSA RAPLEY WATERMAN LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/12/2017
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Provider Practice Location Address
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Address Line | 10 PLAZA STREET EAST SUITE 1C
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City | BROOKLYN
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State | NY
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Zip | 11238
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Country | US
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Telephone | 347-510-9131
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Fax |
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Provider Business Mailing Address
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Address Line | 135-25 HOOVER AVENUE 6M
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City | BRIARWOOD
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State | NY
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Zip | 11435
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Country | US
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Telephone | 917-749-8429
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 100448
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License Number State | NY
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