Organization
EXTRAORDINARY BEINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGETTE SEMONE EDMUND MS. SPED (ABA THERAPIST)
(917) 498-0767
Entity
Organization
Contact information
Practice address
1511 ROYCE ST APT 3I, BROOKLYN, NY 11234-5877
(917) 498-0767
Mailing address
1511 ROYCE ST APT 3I, BROOKLYN, NY 11234-5877
(917) 498-0767
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962817452
NPI
NY
Enumeration date
10/02/2018
Last updated
10/02/2018
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