Individual
LATEFFA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HARRISON AVE UNIT 346, HARRISON, NJ 07029-1687
(201) 899-6279
Mailing address
1 HARRISON AVE UNIT 346, HARRISON, NJ 07029-1687
(201) 899-6279
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
88-3234317
NJ
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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