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Individual

AMY J BARKER-DEPTUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., BCBA, LBA

Contact information

Practice address
21 FAIRWAY DR, MANORVILLE, NY 11949-2909
(516) 635-2292
(631) 909-2960
Mailing address
21 FAIRWAY DR, MANORVILLE, NY 11949-2909
(516) 635-2292

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000839
NY
103TS0200X
School Psychologist
759970
NY

Other

Enumeration date
09/15/2008
Last updated
07/21/2022
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