Individual
MRS. CAROLE ANN BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS.ED, BCBA
Contact information
Practice address
28 1ST ST, LYNBROOK, NY 11563-4104
(516) 599-0859
Mailing address
28 1ST ST, LYNBROOK, NY 11563-4104
(516) 599-0859
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
621509051
NY
Other
Enumeration date
11/05/2012
Last updated
12/21/2012
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