Individual
MISS CHANCELEVIA VERENE MBENGONE MENGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 LANDING RD APT 1L, LANDING, NJ 07850-1509
(318) 418-3682
Mailing address
100 INTERNATIONAL DR, BUDD LAKE, NJ 07828-1383
(833) 282-2223
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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