Individual
KESHIA HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 149TH ST # R, WHITESTONE, NY 11357-3116
(516) 780-0770
Mailing address
193 S PORTLAND AVE APT 3, BROOKLYN, NY 11217-4786
(929) 454-4784
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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