Individual
MRS. MELISSA LAUREN NYLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
189 WHEATLEY ROAD, BROOKVILLE, NY 11545
(516) 626-1000
Mailing address
36 NASSAU AVENUE, GLEN COVE, NY 11542
(516) 650-1851
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1149323
NY
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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