Individual
JESSICA CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS.ED., BCBA
Contact information
Practice address
4917 170TH ST, FRESH MEADOWS, NY 11365-1012
(646) 549-6291
Mailing address
4917 170TH ST, FRESH MEADOWS, NY 11365-1012
(646) 549-6291
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB526371
—
Other
Enumeration date
01/05/2021
Last updated
04/26/2021
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