Individual
NISSI PERAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 GLENN AVE, EGG HARBOR TWP, NJ 08234-6109
(703) 564-1639
Mailing address
39 EVERGREEN AVE, EGG HARBOR TWP, NJ 08234-7246
(609) 665-7380
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/14/2020
Last updated
11/14/2020
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