Individual
MS. LANISA LETANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 MIDWOOD ST, VALLEY STREAM, NY 11580-5108
(631) 704-4685
Mailing address
124 MIDWOOD ST, VALLEY STREAM, NY 11580-5108
(631) 704-4685
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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