Organization
CAN LICENSED BEHAVIOR ANALYSIS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANINO BCBA LBA (OWNER/CLINICIAN)
(516) 220-1049
Entity
Organization
Contact information
Practice address
354 VETERANS MEMORIAL HWY STE 3, COMMACK, NY 11725-4331
(516) 220-1049
Mailing address
354 VETERANS MEMORIAL HWY STE 3, COMMACK, NY 11725-4331
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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