Provider Demographics
NPI:1376058222
Name:RAMBO, DANA STEPHANIE
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:STEPHANIE
Last Name:RAMBO
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 1:1360 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5132
Mailing Address - Country:US
Mailing Address - Phone:646-415-7735
Mailing Address - Fax:718-251-7818
Practice Address - Street 1:1360 E 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5132
Practice Address - Country:US
Practice Address - Phone:646-415-7735
Practice Address - Fax:718-251-7818
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor