Individual
MS. JILL STAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1004 N CLINTON AVE, LINDENHURST, NY 11757-2109
(631) 387-1003
Mailing address
1004 N CLINTON AVE, LINDENHURST, NY 11757-2109
(631) 387-1003
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
781925
NY
Other
Enumeration date
06/04/2012
Last updated
05/28/2024
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