Provider Demographics
NPI:1225399207
Name:LABADIE, JOLEEN ANN (MS, SPEC-ED, TSHH)
Entity Type:Individual
Prefix:MRS
First Name:JOLEEN
Middle Name:ANN
Last Name:LABADIE
Suffix:
Gender:F
Credentials:MS, SPEC-ED, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PITTSBURGH AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4548
Mailing Address - Country:US
Mailing Address - Phone:516-456-8406
Mailing Address - Fax:
Practice Address - Street 1:118 PITTSBURGH AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-4548
Practice Address - Country:US
Practice Address - Phone:516-456-8406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066258012174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist