Individual
ELLEN MARIE DEIESU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(763) 371-8762
Mailing address
15505 86TH ST, HOWARD BEACH, NY 11414-2405
(516) 987-3423
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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