Individual
LORALEE ANNETTE BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6214 24TH AVE, BROOKLYN, NY 11204-3319
(212) 481-4040
Mailing address
6214 24TH AVE, BROOKLYN, NY 11204-3319
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/18/2024
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