Individual
AMANDA BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS BCBA
Contact information
Practice address
3002 LINCOLN DR W, MARLTON, NJ 08053-1527
(856) 810-7599
Mailing address
3002 LINCOLN DR W, MARLTON, NJ 08053-1527
(856) 810-7599
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-15161
PA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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