Individual
KELSEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 AVIS DR STE 101, LATHAM, NY 12110-2650
(518) 560-4277
Mailing address
4 AVIS DR STE 101, LATHAM, NY 12110-2650
(518) 560-4277
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002417
NY
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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