Individual
SAMANTHA GRANITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
230 BRAEN AVE STE D, WYCKOFF, NJ 07481-2948
(973) 423-2254
Mailing address
230 BRAEN AVE STE D, WYCKOFF, NJ 07481-2948
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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