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Individual

DESTINY NICHOLA THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
19-21 FAIR LAWN AVE STE E, FAIR LAWN, NJ 07410-2331
(877) 222-0399
Mailing address
19-21 FAIR LAWN AVE STE E, FAIR LAWN, NJ 07410-2331
(877) 222-0399

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-24-73655
NJ
103K00000X
Behavior Analyst
Primary
1-24-73655

Other

Enumeration date
10/03/2018
Last updated
07/17/2024
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