Individual
JACQUELYN ANNE KLECAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
99 HOLLYWOOD DR, SMITHTOWN, NY 11787-3135
(631) 366-2900
Mailing address
590 PEASE LN, WEST ISLIP, NY 11795-3423
(631) 901-7182
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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