Individual
KIMBERLY VAN SLYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
156 CALDWELL AVE, SAINT JAMES, NY 11780-2804
(631) 525-2477
Mailing address
156 CALDWELL AVE, SAINT JAMES, NY 11780-2804
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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