Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003575101 |
---|---|
Provider Name | Rebecca V Safranek |
First Address | Smithtown, NY 11787-4124 |
Second Address | Massapequa, NY 11758-5338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2021 |
Last Update Date | 16/12/2021 |