Individual
STEPHANIE GOMEZ OVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 MICROLAB RD STE 3, LIVINGSTON, NJ 07039-1640
(862) 253-3109
Mailing address
109 HAGUE ST FL 1, JERSEY CITY, NJ 07307-3103
(201) 640-6806
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NJ
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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