Individual
KOZUE MATSUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 CENTER BLVD, APT 1604, LONG ISLAND CITY, NY 11109-5738
(917) 599-6033
Mailing address
4615 CENTER BLVD, APT 1604, LONG ISLAND CITY, NY 11109-5738
(917) 599-6033
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000841
NY
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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