Individual
ALIJSH VANCE BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
407 GLENN AVE, EGG HARBOR TOWNSHIP, NJ 08234-6109
(609) 218-8864
Mailing address
705 CEDAR AVE, CAPE MAY COURT HOUSE, NJ 08210-2849
(609) 675-8144
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
NJ
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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