Individual
KELSEY JUNE BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
157 BEACH 116TH ST, ROCKAWAY PARK, NY 11694-2430
(631) 786-5236
Mailing address
207 SUYDAM LN, BAYPORT, NY 11705-2152
(631) 786-5236
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NY
106S00000X
Behavior Technician
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
676542130
ALLIANCE FOR SHARED HEALTH
NY
Enumeration date
01/07/2021
Last updated
11/30/2022
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