Individual
SUSAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1118 TILTON RD, NORTHFIELD, NJ 08225-1230
(609) 922-4400
Mailing address
23 BROOKSIDE DR, EGG HARBOR TOWNSHIP, NJ 08234-7416
(609) 453-0991
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12262410
NJ
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/10/2021
Last updated
12/05/2022
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