Most Relevant Information
Provider Data
| NPI Number: | 1003422445 |
| Provider Name: | VANESSE DOUGLAS |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/21/2020 |
| Last Updated: | 09/21/2020 |
Provider Practice Location
2960 GRAND CONCOURSE APT 3C
BRONX
NY
104581905
Practice Location Phone/Fax
| Phone: | 3475775844 |
| Fax: |
Provider Mailing Location
595 MCLEAN AVE APT 6A
YONKERS
NY
107054649
Provider Mailing Phone/Fax
| Phone: | 3477802185 |
| Fax: |