Individual
JACKLYN MASTRIACOVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 E 236TH ST, BRONX, NY 10470-2103
(914) 438-5866
Mailing address
333 E 236TH ST, BRONX, NY 10470-2103
(914) 438-5866
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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