Individual
DR. KIMBERLY SHAMOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
140 EVANS AVE, ELMONT, NY 11003-2619
(516) 354-8562
Mailing address
140 EVANS AVE, ELMONT, NY 11003-2619
(917) 902-0713
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000053-1
NY
103T00000X
Psychologist
020486-1
NY
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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