Individual
JASMINE NICHOLE WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
70 WARTBURG AVE, COPIAGUE, NY 11726
(631) 991-1694
Mailing address
70 WARTBURG AVE, COPIAGUE, NY 11726
(631) 991-1694
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103K00000X
ABA THERAPY
NY
Enumeration date
04/13/2018
Last updated
04/13/2018
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