Individual
DAKOTA TATAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 PARSONAGE RD STE 318, EDISON, NJ 08837-2429
(732) 204-1635
(732) 204-1636
Mailing address
253 PRINCETON AVE, PRINCETON, NJ 08540-1615
(609) 613-2836
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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