Individual
EVELYNE BLAISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1479 E 85TH ST # 2, BROOKLYN, NY 11236-5129
(718) 578-1977
Mailing address
1479 E 85TH ST # 2, BROOKLYN, NY 11236-5129
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
12/23/2017
Last updated
12/23/2017
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