Individual
MS. SAMANTHA BROOKE NIEFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
(718) 762-7633
(718) 886-8694
Mailing address
82 GRISSOM WAY, HAUPPAUGE, NY 11788-4416
(631) 332-0015
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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