Individual
MAVIS LAUREN SMOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6725 CLYDE ST, 2M, FOREST HILLS, NY 11375-4056
(718) 263-5653
Mailing address
6725 CLYDE ST, 2M, FOREST HILLS, NY 11375-4056
(347) 907-1210
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103K00000X
NY
Other
Enumeration date
04/09/2016
Last updated
04/09/2016
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