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General NPI Number Information
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NPI Number | 1811517626
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Entity Type | Individual
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Provider Name | KARA DANIELLE GRAYSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 68 JAY ST STE 409
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City | BROOKLYN
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State | NY
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Zip | 11201-8361
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Country | US
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Telephone | 608-658-1158
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Fax |
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Provider Business Mailing Address
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Address Line | 265 STATE ST APT 811
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City | BROOKLYN
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State | NY
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Zip | 11201-4425
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 092864
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License Number State | NY
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