Individual
MRS. MEGAN M WOLLENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED & BCBA
Contact information
Practice address
651 VANDERBILT ST, APT 7M, BROOKLYN, NY 11218-1265
(650) 464-0761
Mailing address
651 VANDERBILT ST, APT 7M, BROOKLYN, NY 11218-1265
(650) 464-0761
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4022
NY
Other
Enumeration date
11/23/2012
Last updated
11/23/2012
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