Individual
MRS. KATHLEEN SAMBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
322 WOODBRIDGE LN, JERICHO, NY 11753-2629
(917) 691-1705
Mailing address
322 WOODBRIDGE LN, JERICHO, NY 11753-2629
(917) 691-1705
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
196095021
NY
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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