MARVIN THEODORE

STATEN ISLAND, NY
NPI1700393527
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  33621)
Enumeration Date2018-01-02
Last Update Date2018-01-02
Business Address
Mr. MARVIN THEODORE
263 PORT RICHMOND AVE
STATEN ISLAND, NY 10302-1704
Phone number: 718-981-8117
Mailing Address
Mr. MARVIN THEODORE
263 PORT RICHMOND AVE
STATEN ISLAND, NY 10302-1704
Phone number: 718-981-8117
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