Individual
DIAMOND JACKLYN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BACHELOR'S IN ART
Contact information
Practice address
560 CAPOBIANCO PLZ APT D, RAHWAY, NJ 07065-5419
(908) 463-5621
Mailing address
560 CAPOBIANCO PLZ APT D, RAHWAY, NJ 07065-5419
(908) 463-5621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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