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1932839271
JAKE VIDAL
MELVILLE, NY
NPI
1932839271
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TS0200X Psychologist, School
Enumeration Date
2022-06-10
Last Update Date
2022-06-10
Business Address
JAKE VIDAL
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747-4899
Phone number: 631-385-7780
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Mailing Address
JAKE VIDAL
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747-4899
Phone number: 631-385-7780
Copy
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