Individual
MS. ALYSON TERESE DETIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1071 VALLEY RD, STIRLING, NJ 07980-1523
(906) 604-6500
Mailing address
35 WALTON AVE, NEW PROVIDENCE, NJ 07974-1745
(908) 723-6380
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11521250
NJ
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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