Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1012241161 | NY |
NPI | 1124564422 |
---|---|
Provider Name | Ms. Anav Michal Ledersnaider |
First Address | New York, NY 10012-1236 |
Second Address | New York, NY 10002-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2017 |
Last Update Date | 10/01/2017 |