Provider Demographics
NPI:1821308065
Name:STA.ANA-ANTOINE, PIA M (MA EARLY CHILDHOOD)
Entity Type:Individual
Prefix:
First Name:PIA
Middle Name:M
Last Name:STA.ANA-ANTOINE
Suffix:
Gender:F
Credentials:MA EARLY CHILDHOOD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 SCHERMERHORN ST
Mailing Address - Street 2:APT. 9A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6096
Mailing Address - Country:US
Mailing Address - Phone:718-858-8474
Mailing Address - Fax:
Practice Address - Street 1:189 SCHERMERHORN ST
Practice Address - Street 2:APT. 9A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6096
Practice Address - Country:US
Practice Address - Phone:347-416-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1373528103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst