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General NPI Number Information
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NPI Number | 1245544733
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Entity Type | Organization
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Legal Business Name | SUN CREST CONSULTING SERVICES
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 8 SUNCREST DR
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City | DIX HILLS
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State | NY
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Zip | 11746-5733
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Country | US
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Telephone | 631-470-0180
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Fax |
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Provider Business Mailing Address
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Address Line | 8 SUNCREST DR
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City | DIX HILLS
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State | NY
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Zip | 11746-5733
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Country | US
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Telephone | 631-470-0180
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Fax |
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Authorized Official
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Title or Position | APPLIED BEHAVIORAL ANALYST
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Name | MRS. MARY MCDONALD
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Credential | ABA
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Telephone | 631-470-0180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1000060
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License Number State | NY
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