Individual
ELISA CARLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
9 GREENWOOD LN, SAINT JAMES, NY 11780-3427
(631) 707-6936
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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