Individual
MS. KRISTEEN HOPE ELSIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
140 GRASSMERE AVE, OAKDALE, NY 11769-1904
(631) 902-7778
(631) 244-5098
Mailing address
140 GRASSMERE AVE, OAKDALE, NY 11769-1904
(631) 902-7778
(631) 244-5098
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
239546081
NY
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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