Individual
DANIELLE MYRTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NYS LABA, MA LABA
Contact information
Practice address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375-1022
(718) 762-7633
Mailing address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375-1022
(718) 762-7633
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000001131
MA
Other
Enumeration date
08/15/2016
Last updated
11/08/2016
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