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1558021105
NICKEELA JENELLA AUSTIN
MELVILLE, NY
NPI
1558021105
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-12-22
Last Update Date
2021-12-22
Business Address
NICKEELA JENELLA AUSTIN
225 BROADHOLLOW RD STE MELVILLE
MELVILLE, NY 11747-4822
Phone number: 631-385-7780
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Mailing Address
NICKEELA JENELLA AUSTIN
1 LAKE ST
MASSAPEQUA, NY 11758-5508
Phone number: 631-482-0665
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