Provider Demographics
NPI:1942563846
Name:STERLING, JACINTA ROSEMARIE (MSED)
Entity Type:Individual
Prefix:
First Name:JACINTA
Middle Name:ROSEMARIE
Last Name:STERLING
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24918 147TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2422
Mailing Address - Country:US
Mailing Address - Phone:718-723-2282
Mailing Address - Fax:
Practice Address - Street 1:24918 147TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2422
Practice Address - Country:US
Practice Address - Phone:718-723-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-17
Last Update Date:2012-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1724004103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst