Individual
MR. TERENCE G BLACKWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
277 MAIN ST, 1ST FLOOR, SOUTH RIVER, NJ 08882-2042
(732) 254-0300
(732) 254-3131
Mailing address
28 ADDINGTON CT, EAST BRUNSWICK, NJ 08816-5302
(732) 672-3471
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-03-1234
NJ
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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