Individual
MS. STEPHANIE ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13429 166TH PL APT 13D, JAMAICA, NY 11434-3872
(347) 993-6046
Mailing address
13429 166TH PL APT 13D, JAMAICA, NY 11434-3872
(347) 993-6046
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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