Individual
MICHELLE KMIOTEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 SOUTH AVE STE 405, STATEN ISLAND, NY 10314-3414
(866) 707-8669
Mailing address
222 SHELDON AVE, STATEN ISLAND, NY 10312-3018
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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