Individual
MICHELE ELISE MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
39 N VIOLET ST, BETHPAGE, NY 11714-5124
(516) 473-9298
Mailing address
39 N VIOLET ST, BETHPAGE, NY 11714-5124
(516) 473-9298
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000620
NY
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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