Individual
FANGCHI REN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA-NY
Contact information
Practice address
167 MAPLE RD, WADING RIVER, NY 11792-1250
(516) 233-0155
Mailing address
167 MAPLE RD, WADING RIVER, NY 11792-1250
(516) 233-0155
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
003921
NY
103K00000X
Behavior Analyst
Primary
1-24-76863
—
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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