Individual
JACKLYNN ILENE JUDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3858 NOSTRAND AVE, BROOKLYN, NY 11235-2050
(718) 698-1300
Mailing address
1214 E 73RD ST, BROOKLYN, NY 11234-3676
(646) 617-3811
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-75165
NY
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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