Individual
JESSICA THERESE CAPONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED.
Contact information
Practice address
34 WOODLAND RD, MILLER PLACE, NY 11764-1943
(631) 828-6424
Mailing address
34 WOODLAND RD, MILLER PLACE, NY 11764-1943
(631) 828-6424
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
814905
NY
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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