Individual
KYLE MARIE CERVONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
15 MIDDLETON DR, NEW FAIRFIELD, CT 06812
(203) 751-2525
Mailing address
PO BOX 539, PATTERSON, NY 12563-0539
(203) 751-2525
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-11869
NY
Other
Enumeration date
12/10/2012
Last updated
06/12/2018
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