Individual
KHANDISSA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(917) 415-4958
Mailing address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1714304231
NY
Other
Enumeration date
06/22/2023
Last updated
04/25/2025
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