Individual
MRS. KELLY SEGERDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 ELIZABETH ST APT 2K, FARMINGDALE, NY 11735-1973
(516) 732-1665
Mailing address
25 ELIZABETH ST APT 2K, FARMINGDALE, NY 11735-1973
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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