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Individual

JESSICA ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
424 CENTRAL AVE STE 2, WESTFIELD, NJ 07090-2561
(732) 204-1635
Mailing address
3 WILNORA HOLMAN WAY, NEWARK, NJ 07108-1967
(973) 286-9422

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/18/2023
Last updated
07/18/2023
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