Most Relevant Information
Provider Data
| NPI Number: | 1003597998 |
| Provider Name: | JEANNA MARIE GOWDY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/25/2023 |
| Last Updated: | 07/25/2023 |
Provider Practice Location
6214 24TH AVE
BROOKLYN
NY
112043319
Practice Location Phone/Fax
| Phone: | 2124814040 |
| Fax: |
Provider Mailing Location
6214 24TH AVE
BROOKLYN
NY
112043319
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |