Individual
LAQUETA MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2631 MERRICK RD STE 302, BELLMORE, NY 11710-5784
(516) 590-7575
Mailing address
12911 JAMAICA AVE APT 6D, RICHMOND HILL, NY 11418-2665
(516) 514-4528
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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