Individual
THALYA TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 S PARK PL, MORRISTOWN, NJ 07960-3924
(718) 215-5311
(718) 865-5165
Mailing address
PO BOX 360595, PITTSBURGH, PA 15251-6595
(718) 215-5311
(718) 865-5165
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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