Individual
JULIE POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2304 BRUNSWICK AVE, LAWRENCE, NJ 08648-4411
(844) 222-2645
Mailing address
2304 BRUNSWICK AVE, LAWRENCE TOWNSHIP, NJ 08648-4411
(347) 415-7049
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037676
—
NJ
Enumeration date
11/15/2023
Last updated
12/12/2024
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