Individual
KELLY F MIRRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 DEAL RD, ISLAND PARK, NY 11558-1449
(516) 325-4332
Mailing address
21 DEAL RD, ISLAND PARK, NY 11558-1449
(516) 325-4332
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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