Individual
MRS. SHANNAKAY M MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 RIVERLEIGH AVE, RIVERHEAD, NY 11901-3674
(631) 382-7311
Mailing address
20 RIVERLEIGH AVE, RIVERHEAD, NY 11901-3674
(631) 382-7311
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2725533
NY
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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