Individual
MRS. MICHELLE GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
560 NASSAU BLVD, FRANKLIN SQUARE, NY 11010-4337
(516) 481-5780
(516) 505-6988
Mailing address
560 NASSAU BLVD, FRANKLIN SQUARE, NY 11010-4337
(516) 481-5780
(516) 505-6988
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1084815
NY
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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