Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003380056 |
---|---|
Provider Name | Andrea Panebianco |
First Address | Oceanside, NY 11572-5518 |
Second Address | Bellmore, NY 11710-5784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2019 |
Last Update Date | 13/01/2019 |