Individual
ILIANA JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S ED.
Contact information
Practice address
48 BROOKSIDE DR W, HARRIMAN, NY 10926-3018
(917) 832-3688
Mailing address
48 BROOKSIDE DR W, HARRIMAN, NY 10926-3018
(917) 832-3688
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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