Individual
MRS. KRISTINE LOCCISANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS;BCBA
Contact information
Practice address
189 WHEATLEY RD, GLEN HEAD, NY 11545-2641
(516) 626-1075
Mailing address
189 WHEATLEY RD, GLEN HEAD, NY 11545-2641
(516) 626-1075
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1000686
NY
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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