Individual
IRENE GRANDEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. BCBA
Contact information
Practice address
801 BIRCHFIELD DR, MOUNT LAUREL, NJ 08054-4015
(484) 681-2170
Mailing address
583 SHOEMAKER RD STE 230, KING OF PRUSSIA, PA 19406-4201
(484) 681-2170
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28456
NJ
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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