Individual
SORAH CHAYA KOPPENHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
116 E 9TH ST, LAKEWOOD, NJ 08701-2029
(732) 674-9535
Mailing address
116 E 9TH ST, LAKEWOOD, NJ 08701-2029
(732) 674-9535
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/20/2017
Last updated
07/21/2022
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