Individual
MS. FABIENNE NOREVA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 FILLMORE AVE, DEER PARK, NY 11729-7004
(631) 889-2345
Mailing address
116 FILLMORE AVE, DEER PARK, NY 11729-7004
(631) 889-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
10/24/2020
Last updated
10/24/2020
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