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Individual

MICKAYLA CLARICE MUNROE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
609 S 10TH AVE, MOUNT VERNON, NY 10550-4322
(914) 602-5806

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
01/28/2020
Last updated
01/28/2020
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