Individual
MRS. GENEVIEVE ADRIA DUSSAN ROLDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
224 E 135TH ST APT 1905, BRONX, NY 10451-6489
(917) 715-7931
Mailing address
224 E 135TH ST APT 1905, BRONX, NY 10451-6489
(917) 715-7931
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79656
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BACB1036398
BACB ID
NY
Enumeration date
06/25/2018
Last updated
03/27/2025
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