Individual
XIOMARA S CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 149TH ST, WHITESTONE, NY 11357-3116
(516) 780-0770
Mailing address
702 TOWER CT, UNIONDALE, NY 11553-2955
(646) 836-0987
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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