Individual
AYESHA FAZLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
991 MAIN ST, HOLBROOK, NY 11741-1608
(631) 438-1930
Mailing address
3 GARY PL, SELDEN, NY 11784-1508
(631) 877-0800
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NY
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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