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Individual

MS. JACQUELYN ANNE MARINELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSED, BCBS

Contact information

Practice address
81 ARLYN DRIVE EAST, MASSAPEQUA, NY 11758
(631) 327-0836
Mailing address
173 N MAIN ST STE 318, SAYVILLE, NY 11782-2512
(631) 327-0836

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
000606
NY
103TS0200X
School Psychologist
Primary
434735101
NY

Other

Enumeration date
08/08/2012
Last updated
01/07/2022
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