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Individual

ELIZABETH HENNEBORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
73 JUNIPER AVE, RONKONKOMA, NY 11779-5925
(631) 580-0360
Mailing address
73 JUNIPER AVE, RONKONKOMA, NY 11779-5925
(631) 580-0360

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
03/30/2016
Last updated
03/30/2016
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