Individual
MELISSA MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 CALICO TREE ROAD, HAUPPAUGE, NY 11788
(516) 695-1918
Mailing address
9 CALICO TREE RD, HAUPPAUGE, NY 11788-2623
(516) 695-1918
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103K000000X
NY
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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