Individual
DOREEN IVORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 S DORADO CIR APT 2H, HAUPPAUGE, NY 11788-4796
(718) 440-0685
Mailing address
21 S DORADO CIR APT 2H, HAUPPAUGE, NY 11788-4796
(718) 440-0685
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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