Individual
LISA ANN RADIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 FARLEY AVE, FANWOOD, NJ 07023-1004
(727) 492-5369
Mailing address
115 ROSEWOOD TER, LINDEN, NJ 07036-4923
(908) 358-5037
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36879
NJ
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/17/2017
Last updated
09/04/2020
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