Individual
MRS. KELLY MARIE KUYLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
229 LAUREL RD, EAST NORTHPORT, NY 11731-1118
(305) 788-9744
Mailing address
169 WANSER AVE, INWOOD, NY 11096-2114
(305) 788-9744
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0014661
NY
Other
Enumeration date
10/12/2019
Last updated
10/12/2019
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