Individual
MRS. KAITLYN MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
371 E HARRISON ST, LONG BEACH, NY 11561-2349
(631) 741-1160
Mailing address
371 E HARRISON ST, LONG BEACH, NY 11561-2349
(631) 741-1160
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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