Individual
JESSICA DECELIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 MARLOW RD, VALLEY STREAM, NY 11580-3705
(516) 884-7742
Mailing address
11208 204TH ST, SAINT ALBANS, NY 11412-2212
(347) 552-9351
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/13/2021
Last updated
06/13/2021
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