Individual
SAMANTHA SEVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA-NY
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
603 CLINTON ST, BELLMORE, NY 11710-3933
(516) 510-3364
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002380
NY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/23/2019
Last updated
02/17/2024
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