Individual
SHANNIELLE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
63 YALE AVE, IRVINGTON, NJ 07111-2230
(862) 279-8599
Mailing address
63 YALE AVE, IRVINGTON, NJ 07111-2230
(862) 279-8599
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/16/2016
Last updated
07/16/2016
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