Individual
TANISHA LOPEZ SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 AUSTIN ST STE 200, FOREST HILLS, NY 11375-4739
(718) 762-7633
Mailing address
180 TROY AVE APT 14H, BROOKLYN, NY 11213-2289
(917) 586-3531
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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