Individual
VANNAK ROURM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
163 E MAIN ST, LITTLE FALLS, NJ 07424-1711
(973) 339-0141
Mailing address
20 JEFFERSON ST, CLIFTON, NJ 07014-1514
(973) 223-6661
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23266644
NJ
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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