Individual
KELISE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 EVERGREEN RD, ROCKY POINT, NY 11778-8848
(631) 599-2244
Mailing address
28 EVERGREEN RD, ROCKY POINT, NY 11778-8848
(631) 599-2244
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/15/2014
Last updated
06/15/2014
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