Individual
MS. JACQUELINE BODDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1874 PELHAM PKWY S APT 6N, BRONX, NY 10461-3750
(917) 517-2629
Mailing address
1874 PELHAM PKWY S APT 6N, BRONX, NY 10461-3750
(917) 517-2629
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
561048051
NY
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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