Provider Demographics
NPI:1235492307
Name:MULCHINSKI, JO ANN (MSED BCBA)
Entity Type:Individual
Prefix:MISS
First Name:JO
Middle Name:ANN
Last Name:MULCHINSKI
Suffix:
Gender:F
Credentials:MSED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5844 246TH CRES
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2028
Mailing Address - Country:US
Mailing Address - Phone:718-631-7336
Mailing Address - Fax:
Practice Address - Street 1:5844 246TH CRES
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-2028
Practice Address - Country:US
Practice Address - Phone:718-631-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist