Individual
JENNA POLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1737 VETERANS MEMORIAL HWY STE 1, ISLANDIA, NY 11749-1529
(631) 479-2900
Mailing address
79 SOMERSET DR, HOLBROOK, NY 11741-2873
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/29/2019
Last updated
11/29/2019
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