Individual
JENNIFER PHYLLIS RUDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41 JAY ST, BARDONIA, NY 10954-2136
(845) 826-0293
Mailing address
41 JAY ST, BARDONIA, NY 10954-2136
(845) 826-0293
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/21/2015
Last updated
07/21/2015
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