Individual
LILLY KANTAWANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA LBA
Contact information
Practice address
1123 DICKENS ST, FAR ROCKAWAY, NY 11691-2301
(347) 369-2733
Mailing address
43 TOWER RD, BROOKFIELD, CT 06804-3655
(347) 369-2733
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/24/2014
Last updated
12/09/2024
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