Individual
JUNE FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 FERNDALE RD, NEW CITY, NY 10956-6325
(845) 639-9465
Mailing address
32 FERNDALE RD, NEW CITY, NY 10956-6325
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
352498031
NY
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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