Individual
DR. MARY ELLEN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
8 SUNCREST DR, DIX HILLS, NY 11746-5733
(917) 974-4936
Mailing address
86 STANTON ST, NORTHPORT, NY 11768-1631
(631) 757-4041
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-00-0060
FL
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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