Individual
SHAUNA TESONA DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19908 120TH AVE, SAINT ALBANS, NY 11412-3802
(917) 500-8705
Mailing address
19908 120TH AVE, SAINT ALBANS, NY 11412-3802
(191) 750-0870
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2694593
—
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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