Individual
MARCELLA JOHANNA ANDRADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1449 37TH ST STE 300, BROOKLYN, NY 11218-4380
(718) 215-5311
Mailing address
37 OLD COMMACK RD, KINGS PARK, NY 11754-3508
(631) 507-6017
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
P09985
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11623792
BACB
NY
01
—
P09985
NYSED
NY
Enumeration date
04/20/2018
Last updated
06/11/2019
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