Individual
MANDY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
28 HEMLOCK LN, BAY SHORE, NY 11706-7811
(631) 553-0536
Mailing address
28 HEMLOCK LN, BAY SHORE, NY 11706-7811
(631) 553-0536
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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