Individual
TAKIERA DONELLA JEFFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(718) 762-7633
Mailing address
360 WILLIAMS AVE APT 2E, BROOKLYN, NY 11207-4634
(347) 992-7122
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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