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Individual

JACQUELYN J TENENZAPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001417-1
NY

Other

Enumeration date
01/14/2018
Last updated
01/14/2018
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  • EDI platform