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Organization
QUALITY SERVICES FOR THE AUTISM COMMUNITY
Active
Organization
QUALITY SERVICES FOR THE AUTISM COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN DUMOULIN PHD (CLINICAL DIRECTOR)
(718) 728-8476
Entity
Organization
Contact information
Practice address
24537 60TH AVE, DOUGLASTON, NY 11362-2014
(718) 728-8476
(718) 229-7359
Mailing address
253 W 35TH ST, 16TH FLOOR, NEW YORK, NY 10001-1907
(718) 728-8476
(718) 229-7539
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
031992-1
NY
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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