Individual
REGINA MISIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12503 135TH AVE, SOUTH OZONE PARK, NY 11420-3207
(347) 239-8371
Mailing address
12503 135TH AVE, SOUTH OZONE PARK, NY 11420-3207
(347) 239-8371
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1346254191
NY
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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