Individual
LISA DATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
AJ BEHAVORIAL, 2631 MERRICK ROAD SUITE 302 BELLMORE, NY 11710, BELLMORE,, NY 11710
(516) 590-7575
Mailing address
20 STARGAZER DR, EASTPORT, NY 11941-1629
(631) 624-7740
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NY
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103K00000X
AJ BEHAVIORAL
NY
Enumeration date
09/03/2021
Last updated
09/03/2021
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