Individual
MRS. LIA L RICARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPECIAL ED. TEACHER
Contact information
Practice address
2307 207TH ST, BAYSIDE, NY 11360-1349
(718) 423-1796
Mailing address
2307 207TH ST, BAYSIDE, NY 11360-1349
(718) 423-1796
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1475572
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1475572
NEW YORK STATE EDUCATION DEPARTMENT
NY
01
—
26438
STATE OF NEW YORK DEPARTMENT OF HEALTH
—
Enumeration date
10/26/2010
Last updated
10/26/2010
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