Individual
KIMBERLY DUTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 CENTRE ST, FREEPORT, NY 11520-3105
(516) 497-2975
Mailing address
121 CENTRE ST, FREEPORT, NY 11520-3105
(516) 497-2975
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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