Individual
EARL TEVIN ZELAYA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 ARDMORE DR, BRENTWOOD, NY 11717-2338
(631) 383-0522
(631) 383-0522
Mailing address
6 ARDMORE DR, BRENTWOOD, NY 11717-2338
(631) 383-0522
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123
J&A BEHAVIORAL
—
Enumeration date
02/19/2022
Last updated
02/19/2022
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