Provider Information for 1043611841
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YASMIN ROSE BOTTE LMHC
Sex: Female
NPI: 1043611841
Last Updated: 2016-11-04
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1043611841 | ||||||||
| Enumeration Date | 2014-09-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 526 AMHERST AVE STATEN ISLAND, NY 10306-5325 United States Phone: 347-948-5077 | Fax:347-394-2152 | ||||||||
| Primary Practice Address | 345 GUYON AVENUE ROOM 14 STATEN ISLAND, NY 10306-5306 United States Phone: 347-948-5077 | Fax:347-394-2152 | ||||||||
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