Organization
QUALITY SERVICES FOR THE AUTISM COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN DUMOULIN PHD (CLINICAL DIRECTOR)
(718) 728-8476
Entity
Organization
Contact information
Practice address
24537 60TH AVE, DOUGLASTON, NY 11362-2014
(718) 728-8476
(718) 229-7359
Mailing address
253 W 35TH ST, 16TH FLOOR, NEW YORK, NY 10001-1907
(718) 728-8476
(718) 229-7539
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
031992-1
NY
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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