Individual
MELISSA BRUNJES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 MAPLE ST, MALVERNE, NY 11565-1311
(516) 606-8960
Mailing address
33 MAPLE ST, MALVERNE, NY 11565-1311
(516) 606-8960
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
745701485
—
NY
Enumeration date
08/01/2022
Last updated
08/01/2022
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