Individual
HAILEY N MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 N LIBERTY DR STE 10, STONY POINT, NY 10980-2450
(845) 267-0920
Mailing address
1460 NW VIVION RD, KANSAS CITY, MO 64118-4555
(816) 853-0946
(816) 396-8809
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2391
NY
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-133328
BACB
MO
Enumeration date
09/21/2020
Last updated
08/24/2022
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