Individual
LIANE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
4 HOYT ST, SOUTH SALEM, NY 10590-1320
(914) 318-2847
Mailing address
4 HOYT ST, SOUTH SALEM, NY 10590-1320
(914) 318-2847
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16012
—
174400000X
Specialist
171828
NY
Other
Enumeration date
06/24/2012
Last updated
09/02/2014
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