Individual
JENNIFER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, BCBA, LBA
Contact information
Practice address
5 MANOR DR APT 2A, NEWARK, NJ 07106-3237
(201) 706-1355
Mailing address
5 MANOR DR APT 2A, NEWARK, NJ 07106-3237
(201) 706-1355
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/28/2015
Last updated
08/02/2022
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