Provider Demographics
NPI:1295467991
Name:NAVARRO, ANASTASIA RAPHAELL
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:RAPHAELL
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 5TH AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4622
Mailing Address - Country:US
Mailing Address - Phone:347-303-3881
Mailing Address - Fax:
Practice Address - Street 1:53 5TH AVE APT 3L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4622
Practice Address - Country:US
Practice Address - Phone:347-303-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling