Individual
DJEDLOVE VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 WISTERIA DR APT 2E, FORDS, NJ 08863-1142
(732) 585-8721
Mailing address
12 WISTERIA DR APT 2E, FORDS, NJ 08863-1142
(732) 585-8721
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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