Individual
NICOLE C MACAVOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 MARKET ST, PORT NORRIS, NJ 08349-3105
(856) 982-6688
Mailing address
2525 MARKET ST, PORT NORRIS, NJ 08349-3105
(856) 982-6688
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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