Individual
KYANNA Y HAWKINS-DERAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
46 ELIZABETH ST, PEMBERTON, NJ 08068-1216
(609) 316-0195
Mailing address
46 ELIZABETH ST, PEMBERTON, NJ 08068-1216
(609) 316-0195
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/19/2019
Last updated
03/21/2019
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