Individual
MS. JENIFER SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
325 FISHER STREET, BABYLON, NY 11758
(516) 357-6834
Mailing address
327 6TH ST APT A, LINDENHURST, NY 11757-1122
(516) 305-2929
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1139559
NY
Other
Enumeration date
04/16/2019
Last updated
11/30/2020
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