Individual
MRS. BLAIR POLHEMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1970 SWARTHMORE AVE STE 4, LAKEWOOD, NJ 08701-4553
(908) 675-0029
Mailing address
1479 EARIE WAY, FORKED RIVER, NJ 08731-4057
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66424
NJ
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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