Individual
RIVKAH MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS BCBA
Contact information
Practice address
24 NUSSBAUM AVE, LAKEWOOD, NJ 08701-4677
(347) 798-7831
Mailing address
24 NUSSBAUM AVE, LAKEWOOD, NJ 08701-4677
(347) 798-7831
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-57003
NJ
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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