Provider Demographics
NPI:1326349648
Name:KUESSOUS, CHANA
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:KUESSOUS
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 1:1795 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2201
Mailing Address - Country:US
Mailing Address - Phone:718-787-1100
Mailing Address - Fax:718-787-9598
Practice Address - Street 1:1795 E 8TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2201
Practice Address - Country:US
Practice Address - Phone:718-787-1100
Practice Address - Fax:718-787-9598
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health