Individual
JACQUELINE SOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
127 OLD CHANGEBRIDGE RD, MONTVILLE, NJ 07045-9400
(973) 738-3056
Mailing address
127 OLD CHANGEBRIDGE RD, MONTVILLE, NJ 07045-9400
(973) 738-3056
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44703
NJ
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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