Provider Demographics
NPI:1124530894
Name:SUBI GUZMAN, JUANA (MCH-LP)
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:
Last Name:SUBI GUZMAN
Suffix:
Gender:F
Credentials:MCH-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 BRONXWOOD AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-4513
Mailing Address - Country:US
Mailing Address - Phone:929-263-5941
Mailing Address - Fax:
Practice Address - Street 1:8930 114TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-3028
Practice Address - Country:US
Practice Address - Phone:718-659-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health