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1659024867
ELLYA INDRADJAJA
ASTORIA, NY
NPI
1659024867
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NY 011692)
Enumeration Date
2022-01-27
Last Update Date
2022-01-27
Business Address
ELLYA INDRADJAJA LMHC
3089 31ST ST APT 1
ASTORIA, NY 11102-1975
Phone number: 646-377-9724
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Mailing Address
ELLYA INDRADJAJA LMHC
3089 31ST ST APT 1
ASTORIA, NY 11102-1975
Phone number: 646-377-9724
Copy
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