Individual
ALEXANDRA WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
500 BI COUNTY BLVD STE 450, FARMINGDALE, NY 11735-3995
(631) 388-7813
Mailing address
630 SHORE RD APT 322, LONG BEACH, NY 11561-4620
(631) 987-0089
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VQA483M92106
—
NY
Enumeration date
08/25/2020
Last updated
11/27/2023
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