Provider Demographics
NPI:1801127311
Name:GILLINS-CLARKSON, ROSLYN SABRINA
Entity type:Individual
Prefix:MRS
First Name:ROSLYN
Middle Name:SABRINA
Last Name:GILLINS-CLARKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4221
Mailing Address - Country:US
Mailing Address - Phone:718-493-6410
Mailing Address - Fax:718-493-6410
Practice Address - Street 1:326 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4221
Practice Address - Country:US
Practice Address - Phone:718-493-6410
Practice Address - Fax:718-493-6410
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst