Individual
REBECCA DATILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
474 FURROWS RD, HOLBROOK, NY 11741-2722
(631) 294-0221
Mailing address
474 FURROWS RD, HOLBROOK, NY 11741-2722
(631) 294-0221
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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