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Individual

JACQUELYN RAVENDEN FELICIANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
32 UNION SQ E, NEW YORK, NY 10003-3209
(212) 678-0252
Mailing address
110 SAINT JAMES PL APT 1, BROOKLYN, NY 11238-1813
(443) 797-4057

Taxonomy

Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
002612
NY

Other

Enumeration date
05/27/2020
Last updated
11/22/2021
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