Individual
LAUREN JAQUAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2322 30TH RD APT 5E, ASTORIA, NY 11102-3262
(860) 655-0787
Mailing address
2322 30TH RD APT 5E, ASTORIA, NY 11102-3262
(860) 655-0787
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001913-01
NY
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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