Individual
MRS. ETTIL KAMENETZKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED BCBA
Contact information
Practice address
11 COLORADO DR, JACKSON, NJ 08527-2107
(516) 776-7834
Mailing address
11 COLORADO DR, JACKSON, NJ 08527-2107
(516) 776-7834
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-3695
NJ
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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