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866-327-5145 | info@LICCD.net

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Refer a Child

First Name

Last Name

Email

Phone

I am a .... *

Therapist

Healthcare Provider

Other

Child's Name

Child's DOB * required

Areas of Concern

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Contact Us

Long Island Center for Child Development

626 RXR Plaza

West Tower 6th Floor

Uniondale, NY 11556

Tel: 866-327-5145

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