Individual
MRS. JENNIFER HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.ED, BCBA
Contact information
Practice address
538 BROADHOLLOW RD, MELVILLE, NY 11747-3676
(631) 385-7780
Mailing address
17 JERUSALEM HOLLOW RD, MANORVILLE, NY 11949-3121
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7652
NY
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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