Individual
SHANICE AYANA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23953 148TH RD, ROSEDALE, NY 11422-3268
(347) 301-1423
Mailing address
7000 AUSTIN ST, FOREST HILLS, NY 11375-1022
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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