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Individual

TAMMY KATANOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2625 E 14TH ST, BROOKLYN, NY 11235-3979
(718) 769-2698
Mailing address
6703 UTOPIA PKWY, FRESH MEADOWS, NY 11365-3429
(347) 830-5363

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
CITY PRO GOUP
Enumeration date
11/01/2018
Last updated
11/01/2018
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