Individual
ELYANA IMMACULA JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 E 35TH ST, NEW YORK, NY 10016-4202
(646) 964-5913
Mailing address
204 E 35TH ST, NEW YORK, NY 10016-4202
(646) 964-5913
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
829485361
NY
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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