Individual
MISS CARLA ESTEFANY AGAMA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
6125 97TH ST APT 6R, REGO PARK, NY 11374-1231
(347) 833-1099
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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