Individual
MISS MALISSA MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 CABIN LN, EAST SETAUKET, NY 11733-3442
(631) 871-8629
Mailing address
34 CABIN LN, EAST SETAUKET, NY 11733-3442
(631) 871-8629
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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