Individual
MILDRED M BURGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 GRAND CONCOURSE APT 6O, BRONX, NY 10451-2606
(646) 599-2543
Mailing address
1020 GRAND CONCOURSE APT 6O, BRONX, NY 10451-2606
(646) 599-2543
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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