Individual
JENETTA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
538 BROADHOLLOW RD STE 202, MELVILLE, NY 11747-3668
(631) 358-7780
Mailing address
11107 203RD ST, SAINT ALBANS, NY 11412-2225
(718) 962-4978
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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