Individual
STACEY GOUZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 BERNARD STREET, FARMINGDALE, NY 11735
(516) 376-7522
Mailing address
29 BERNARD ST, FARMINGDALE, NY 11735-3023
(516) 376-7522
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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