Most Relevant Information
Provider Data
| NPI Number: | 1003571878 |
| Provider Name: | RAQUEL FERNANDES |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/05/2021 |
| Last Updated: | 11/13/2021 |
Provider Practice Location
3600 ROUTE 112
CORAM
NY
117274116
Practice Location Phone/Fax
| Phone: | 6319208500 |
| Fax: |
Provider Mailing Location
3600 ROUTE 112
CORAM
NY
117274116
Provider Mailing Phone/Fax
| Phone: | 6319208500 |
| Fax: |