Individual
DEIRDRE KOZYRSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 BALBOA DR, KINGS PARK, NY 11754-4406
(631) 512-2883
Mailing address
14 BALBOA DR, KINGS PARK, NY 11754-4406
(631) 512-2883
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000862
NY
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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