Individual
SHANETTE DANALLE BUGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
1420 REDFERN AVE APT 7E, FAR ROCKAWAY, NY 11691-3802
(347) 314-0980
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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