Individual
MOLLY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
234 AVENUE C, RONKONKOMA, NY 11779-1918
(631) 553-8060
Mailing address
234 AVENUE C, RONKONKOMA, NY 11779-1918
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-57506
NY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/08/2019
Last updated
07/25/2024
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