Individual
GUADALUPE JEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPECIAL EDUCATOR
Contact information
Practice address
369 E 148TH ST STE 200, BRONX, NY 10455-4041
(718) 769-2698
(718) 943-7035
Mailing address
2081 CRUGER AVE APT 2N, BRONX, NY 10462-2333
(917) 613-8517
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
444534041
NY
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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