Individual
LAUREN SELEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 LONGWOOD RD, MIDDLE ISLAND, NY 11953-2045
(631) 924-0008
Mailing address
PO BOX 12, MIDDLE ISLAND, NY 11953-0012
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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