Individual
CLARISSA ANTONIA GRULLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, MA
Contact information
Practice address
623 W 204TH ST, NEW YORK, NY 10034-3932
(917) 293-3114
Mailing address
623 W 204TH ST APT 54, NEW YORK, NY 10034-3961
(917) 293-3114
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NY
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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