Individual
KELLEY S BASILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20920 42ND AVE, 2ND FLOOR, BAYSIDE, NY 11361-2750
(718) 423-0247
Mailing address
20920 42ND AVE, 2ND FLOOR, BAYSIDE, NY 11361-2750
(718) 423-0247
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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