Individual
SHANTAL ENEDINA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11655 QUEENS BLVD, FOREST HILLS, NY 11375-7025
(917) 403-8211
Mailing address
540 AUDUBON AVE APT 59, NEW YORK, NY 10040-3305
(646) 852-5834
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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