Individual
PROF. BRIAN WANSINK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
159 REACH RUN, ITHACA, NY 14850-8501
(607) 229-3896
Mailing address
159 REACH RUN, ITHACA, NY 14850-8501
(607) 220-6050
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/22/2021
Last updated
12/22/2021
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