Individual
NICOLE VIVIAN LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
229 LAUREL RD, EAST NORTHPORT, NY 11731-1118
(631) 659-3337
Mailing address
6 JOHNSON AVE N, KINGS PARK, NY 11754-3519
(631) 316-5870
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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