Individual
MRS. ASHLEY NICOLE HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7760
(631) 385-7795
Mailing address
30 INDIAN HEAD DR, SAYVILLE, NY 11782-1703
(631) 793-4429
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
225800000X
Recreation Therapist
66289
NY
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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