Provider Demographics
NPI:1982130381
Name:PRICE, VANESSA A
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:A
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7023 66TH ST
Mailing Address - Street 2:APARTMENT 2L
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-6553
Mailing Address - Country:US
Mailing Address - Phone:347-821-7305
Mailing Address - Fax:
Practice Address - Street 1:7023 66TH ST
Practice Address - Street 2:APARTMENT 2L
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-6553
Practice Address - Country:US
Practice Address - Phone:347-821-7305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst