Organization
MOMENTUM LICENSED BEHAVIOR ANALYSIS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JILL HICKEY MA, BCBA, LBA (OWNER/PRESIDENT)
(718) 730-2814
Entity
Organization
Contact information
Practice address
3158 12TH ST FL 2, ASTORIA, NY 11106-4804
(718) 730-2814
Mailing address
3158 12TH ST FL 2, ASTORIA, NY 11106-4804
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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