Individual
CHARISSA HOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 S HARRISON ST STE 311, EAST ORANGE, NJ 07018-1960
(862) 253-3109
Mailing address
280 S HARRISON ST STE 311, EAST ORANGE, NJ 07018-1960
(862) 253-3109
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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