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1275955759
DARRELL DEVONISH
JAMAICA, NY
NPI
1275955759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 27920)
Enumeration Date
2014-01-17
Last Update Date
2014-01-17
Business Address
Mr. DARRELL DEVONISH CASAC-T
11630 SUTPHIN BLVD
JAMAICA, NY 11434-1527
Phone number: 718-322-2500
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Mailing Address
Mr. DARRELL DEVONISH CASAC-T
108 EDGECOMBE AVE 1B
NEW YORK, NY 10030-1939
Phone number:
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