Individual
MS. MARLENE FABIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
466 MAIN ST STE LL20, NEW ROCHELLE, NY 10801-6431
(718) 769-2698
Mailing address
1014 GERARD AVE APT 5G, BRONX, NY 10452-9234
(646) 879-6673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NY
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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