Individual
MS. KELLY BERARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 ROSEDALE RD, VALLEY STREAM, NY 11581-2703
(516) 224-0240
Mailing address
186 OAKLEY AVE, ELMONT, NY 11003-2520
(516) 567-7796
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1719606
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1719606
EDUCATION
NY
Enumeration date
12/03/2019
Last updated
12/03/2019
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