Individual
MS. COLLEEN READE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS. ED SBL/SDL
Contact information
Practice address
4722 213TH ST, BAYSIDE, NY 11361-3328
(516) 770-7186
Mailing address
4722 213TH ST, BAYSIDE, NY 11361-3328
(516) 770-7186
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
453025041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17400000X
—
NY
Enumeration date
06/28/2012
Last updated
06/28/2012
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