Individual
JENNIFER COLOMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
275 SLATER BLVD, STATEN ISLAND, NY 10305-4045
(917) 293-4211
Mailing address
275 SLATER BLVD, STATEN ISLAND, NY 10305-4045
(917) 293-4211
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1390996
NY
174400000X
Specialist
1390996
NY
Other
Enumeration date
09/06/2014
Last updated
09/05/2023
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