Individual
LISA MARIE FORSYTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, BCBA
Contact information
Practice address
232 91ST ST, BROOKLYN, NY 11209-5712
(718) 490-7591
Mailing address
232 91ST ST, BROOKLYN, NY 11209-5712
(718) 490-7591
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-04-1940
NY
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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