Individual
JUANA EUGENIA BOLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1071 VALLEY RD, STIRLING, NJ 07980-1523
(908) 604-4500
Mailing address
1071 VALLEY RD, STIRLING, NJ 07980-1523
(908) 604-4500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29332
NJ
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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