Individual
JARED MCCONLOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 POND LN, LEVITTOWN, NY 11756-1149
(516) 796-8485
Mailing address
70 POND LN, LEVITTOWN, NY 11756-1149
(516) 796-8485
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB474504
NY
106E00000X
Assistant Behavior Analyst
BACB474504
NY
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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