Individual
MRS. ERIN KELLY CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
164 FORDHAM AVE, MEDFORD, NY 11763-3132
(631) 617-3583
Mailing address
164 FORDHAM AVE, MEDFORD, NY 11763-3132
(631) 617-3583
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000311-1
NY
174400000X
Specialist
—
NY
Other
Enumeration date
06/14/2012
Last updated
06/29/2016
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