Individual
RENEECE MCTYSON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16110 UNION TPKE, FRESH MEADOWS, NY 11366-1980
(000) 000-0000
Mailing address
16110 UNION TPKE, FRESH MEADOWS, NY 11366-1980
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB552382
NY
Other
Enumeration date
12/12/2024
Last updated
01/17/2025
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