Most Relevant Information
Provider Data
| NPI Number: | 1003446345 |
| Provider Name: | ASTRIDE MOMPREMIER |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/24/2020 |
| Last Updated: | 01/24/2020 |
Provider Practice Location
214-10 24THAVENUE
SUITE2
BAYSIDE
NY
11360
Practice Location Phone/Fax
| Phone: | 3473214094 |
| Fax: |
Provider Mailing Location
214-10 24THAVENUE
SUITE2
BAYSIDE
NY
11360
Provider Mailing Phone/Fax
| Phone: | 3473214094 |
| Fax: |