Individual
JOANE DESTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 RANDALL AVE, FREEPORT, NY 11520-2647
(516) 462-3164
(516) 706-1782
Mailing address
220 RANDALL AVE, FREEPORT, NY 11520-2647
(516) 462-3164
(516) 706-1782
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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