Individual
SIMONE WOHLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58 BIRCH ST, LAKEWOOD, NJ 08701-4701
(732) 597-3487
Mailing address
426 N LAKE DR APT 1A1, LAKEWOOD, NJ 08701-2569
(718) 564-5575
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14758
NJ
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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