Individual
MS. JEONGEUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
22 W COLUMBIA ST, HEMPSTEAD, NY 11550-2411
(516) 331-1587
Mailing address
22 W COLUMBIA ST, HEMPSTEAD, NY 11550-2411
(516) 331-1587
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001756
NY
Other
Enumeration date
09/01/2019
Last updated
09/01/2019
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