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1164686242
GILA WISEMON
BROOKLYN, NY
NPI
1164686242
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 18895)
Enumeration Date
2008-07-17
Last Update Date
2008-07-30
Business Address
-- GILA WISEMON CASAC-T
3619 QUENTIN RD
BROOKLYN, NY 11234-4203
Phone number: 718-998-7500
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Mailing Address
-- GILA WISEMON CASAC-T
PO BOX 31094
HARTFORD, CT 06150-1094
Phone number: 518-952-8140
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