TRACEY MICHELLE MATA

STATEN ISLAND, NY
NPI1083286116
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: NY  1862311)
Enumeration Date2021-07-16
Last Update Date2021-07-16
Business Address
TRACEY MICHELLE MATA
82 ARLO RD APT 1B
STATEN ISLAND, NY 10301-3879
Phone number: 347-885-3004
Mailing Address
TRACEY MICHELLE MATA
82 ARLO RD APT 1B
STATEN ISLAND, NY 10301-3879
Phone number: 347-885-3004
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