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142 B120 Street Rockaway Street NY 11694 | |
(917) 881-5511 | |
Not Available |
Full Name | |
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Speciality | Behavior Analyst |
Location | 142 B120 Street, Rockaway Street, New York |
Authorized Official Name and Position | Laura Leonard (OWNER) |
Authorized Official Contact | 9178815511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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142 B120 Street Rockaway Park NY 11694 Ph: () - | 142 B120 Street Rockaway Street NY 11694 Ph: (917) 881-5511 |
NPI Number | 1275026684 |
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Provider Enumeration Date | 06/11/2018 |
Last Update Date | 06/11/2018 |
Identifier | Type | State | Issuer |
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1275026684 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103K00000X | Behavior Analyst | (* (Not Available)) | Primary |