Individual
MRS. PENINA ESTHER GOURDJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA NYS
Contact information
Practice address
341 TRINITY PL, MALVERNE, NY 11565-1234
(516) 229-1194
Mailing address
162 FAIRLAWN AVE, WEST HEMPSTEAD, NY 11552-2106
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002149
NY
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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