Individual
ZAIDA YADIRA BOULOGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58 PARK PL, IRVINGTON, NJ 07111-2333
(908) 357-3169
Mailing address
58 PARK PL, IRVINGTON, NJ 07111-2333
(908) 357-3169
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NJ
Other
Enumeration date
12/17/2018
Last updated
02/14/2021
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