Individual
SHANNAN BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 OLD COUNTRY RD STE C103N, WESTBURY, NY 11590-5156
(917) 232-6828
Mailing address
1400 OLD COUNTRY ROAD, SUITE C103N, WESTBURY, NY 11590
(917) 232-6828
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
01/04/2011
Last updated
09/21/2023
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