Individual
JUSTIN SPADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 BERKSHIRE RD, OLD BRIDGE, NJ 08857-1602
(732) 401-6988
Mailing address
24 BERKSHIRE RD, OLD BRIDGE, NJ 08857-1602
(732) 401-6988
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-159059
NJ
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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