Individual
KYLIE M MAWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 E FAYETTE ST, SYRACUSE, NY 13210-1022
(315) 732-3431
Mailing address
94 MIDLAKE CIR, EAST SYRACUSE, NY 13057-3108
(631) 512-1203
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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