Individual
LIETEA WILKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 PEARSALL AVE APT 2, JERSEY CITY, NJ 07305-1814
(973) 385-9801
Mailing address
400 RARITAN AVE, HIGHLAND PARK, NJ 08904-2740
(732) 845-6602
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12367037
NJ
103K00000X
Behavior Analyst
Primary
15BC00294500
NJ
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/20/2023
Last updated
05/11/2026
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