Individual
MRS. NICOLE IACULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA BCBA
Contact information
Practice address
19 BOOKDALE RD, EAST BRUNSWICK, NJ 08816
(908) 208-3819
Mailing address
19 BOOKDALE RD, EAST BRUNSWICK, NJ 08816
(908) 208-3819
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-12222
NJ
Other
Enumeration date
10/30/2013
Last updated
10/30/2013
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