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Individual

JESSICA STEPHANIE BOISROND-CANAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(718) 762-7633
Mailing address
152 WEEKS DR, DIX HILLS, NY 11746-6216

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1495553211
NY

Other

Enumeration date
06/04/2021
Last updated
06/12/2021
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