Individual
JESSICA CORBETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46 CHURCH RD, LEVITTOWN, NY 11756-2231
(917) 439-7561
Mailing address
46 CHURCH RD, LEVITTOWN, NY 11756-2231
(917) 439-7561
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
752496131
NY
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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