Individual
JENNIFER DE VASTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2631 MERRICK RD STE 302, BELLMORE, NY 11710-5784
(516) 590-7573
Mailing address
11642 221ST ST, CAMBRIA HEIGHTS, NY 11411-1611
(347) 255-2509
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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