Individual
REBECCA MICIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1224 BAKER ST, HILLSIDE, NJ 07205-2612
(646) 571-7898
Mailing address
1224 BAKER ST, HILLSIDE, NJ 07205-2612
(646) 571-7898
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
NJ
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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