Individual
TANYA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
1776 AVENUE OF THE STATES, LAKEWOOD, NJ 08701-4591
(732) 730-0700
Mailing address
11660 CHURCH ST APT 9, RANCHO CUCAMONGA, CA 91730-8918
(909) 240-6848
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-63138
CA
Other
Enumeration date
10/12/2020
Last updated
02/25/2025
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