Individual
MS. TWALENA ELAINE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 BRENTWOOD RD, BAY SHORE, NY 11706-3204
(631) 214-6251
Mailing address
1500 BRENTWOOD RD, BAY SHORE, NY 11706-3204
(631) 214-6251
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/25/2021
Last updated
09/25/2021
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