Individual
BASIRAH CHANEL BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2 INDUSTRIAL WAY W STE 203, EATONTOWN, NJ 07724-2266
(732) 982-2888
Mailing address
2 INDUSTRIAL WAY W STE 203, EATONTOWN, NJ 07724-2266
(732) 982-2888
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00786300
NJ
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
11/15/2022
Last updated
04/08/2024
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