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Individual

MRS. DAWN CRYSTAL GUDMUNDSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
229 LAUREL RD, EAST NORTHPORT, NY 11731-1118
(484) 965-9966
(484) 231-8631
Mailing address
640 FREEDOM BUSINESS CTR DR STE 220, KING OF PRUSSIA, PA 19406-1376
(484) 965-9966
(484) 231-8631

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001033
NY
251S00000X
Community/Behavioral Health Agency
504297111
NY
251S00000X
Community/Behavioral Health Agency
703164131
NY

Other

Enumeration date
08/19/2013
Last updated
08/30/2021
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