Individual
MRS. HEATHER THOMASSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED., NCSP
Contact information
Practice address
905 ANNADALE RD, STATEN ISLAND, NY 10312-4010
(718) 984-5826
Mailing address
42 QUINLAN AVE, STATEN ISLAND, NY 10314-4012
(917) 847-9328
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
431254101
NY
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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