Individual
MADELINE REBECCA MEYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
991 MAIN ST STE 100, HOLBROOK, NY 11741-1608
(631) 676-5645
Mailing address
2 MOTT DR, BELLPORT, NY 11713-2418
(631) 428-5912
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
231741653
NY
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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