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General NPI Number Information
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NPI Number | 1497174171
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Entity Type | Individual
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Provider Name | JANINE MARIE URIBE M.A.S
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Gender | Female
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 436 WILLIS AVE STE 1
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2298
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Country | US
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Telephone | 516-741-0729
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Fax |
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Provider Business Mailing Address
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Address Line | 14208 HORACE HARDING EXPWY, #3 FL
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City | FLUSHING
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State | NY
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Zip | 11367
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Country | US
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Telephone | 347-840-0154
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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