Individual
MARY MFUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 149TH ST, WHITESTONE, NY 11357-3116
(516) 780-0770
Mailing address
1700 ALBEMARLE RD APT 5E, BROOKLYN, NY 11226-4617
(347) 259-3953
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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