Individual
JENNIFER KOURASSANIS-VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
305 HILLSIDE AVE, WILLISTON PARK, NY 11596-2102
(516) 741-0729
Mailing address
305 HILLSIDE AVE, WILLISTON PARK, NY 11596-2102
(516) 741-0729
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11313203
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
026612
NY
Other
Enumeration date
08/24/2013
Last updated
11/20/2024
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