Individual
MRS. BECKI NAOMI BOUSSIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. ED
Contact information
Practice address
538 BROADHOLLOW RD, SUITE 202, MELVILLE, NY 11747-3676
(631) 385-7780
Mailing address
7 VERNON ST, PLAINVIEW, NY 11803-4603
(917) 783-5340
(516) 935-2867
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
639360
NY
Other
Enumeration date
02/03/2007
Last updated
06/14/2012
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