Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JESSICA AGBOSSOUMONDE
Active Sole ProprietorJESSICA AGBOSSOUMONDE is a Psych/Mental Health, Child & Adolescent Nurse healthcare provider located in GOSHEN, New York. NPI 1477337509 is currently active in the NPPES registry. Verify at CMS.
Psych/Mental Health, Child & Adolescent Nurse · GOSHEN, NY
Registration Details
- NPI Number
- 1477337509
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 21, 2023 (3.0282150475359 yrs)
- Last Updated
- Aug 21, 2023
- License
-
664955 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
18 CRAIGVILLE RDGOSHEN, NY, 109242209Browse NY providers · Browse ZIP 10924
- Phone
- 7572923113
- Primary Specialty
-
Psych/Mental Health, Child & Adolescent Nurse
163WX1500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.