Individual
MISS NI DAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14102 LABURNUM AVE, FLUSHING, NY 11355-3537
(347) 986-8678
Mailing address
14102 LABURNUM AVE, FLUSHING, NY 11355-3537
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12155545
NY
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
NY
Other
Enumeration date
05/02/2013
Last updated
06/28/2024
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