Individual
TIFFANY LARUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 REGENT ST STE 708, LIVINGSTON, NJ 07039-1628
(551) 237-4646
Mailing address
7 REGENT ST STE 708, LIVINGSTON, NJ 07039-1628
(551) 237-4646
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66313
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-158668
RBT CERT
—
Enumeration date
11/09/2021
Last updated
06/22/2023
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