Individual
MISS TENNILLE V VALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1979 MARCUS AVE, SUITE 204, NEW HYDE PARK, NY 11042-1002
(516) 327-4681
Mailing address
1979 MARCUS AVE, SUITE 204, NEW HYDE PARK, NY 11042-1002
(516) 327-4681
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
007071
NY
252Y00000X
Early Intervention Provider Agency
007071
NY
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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