Individual
DEIRDRE M. WEATHERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, RBT, BCBA, LBA
Contact information
Practice address
351 DOVER ST, WESTBURY, NY 11590-3205
(917) 882-0429
Mailing address
351 DOVER ST, WESTBURY, NY 11590-3205
(917) 882-0429
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20674
CO
103K00000X
Behavior Analyst
1196
NY
Other
Enumeration date
11/20/2015
Last updated
01/16/2016
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