Individual
MISS LISA T DEL TEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SPED B-2
Contact information
Practice address
298 33RD ST, LINDENHURST, NY 11757-3237
(631) 495-3757
Mailing address
298 33RD ST, LINDENHURST, NY 11757-3237
(631) 495-3757
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
471683101
NY
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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