Individual
LESLIE BANOS BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 CLIFFWOOD AVE, MATAWAN, NJ 07747-3908
(732) 466-3993
Mailing address
14 CLIFFWOOD AVE, MATAWAN, NJ 07747-3908
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1452322
NJ
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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