Individual
MISS MARISSA GRACE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
8 ROBERT CT APT B2, WEST ORANGE, NJ 07052-6216
(201) 615-1687
Mailing address
8 ROBERT CT APT B2, WEST ORANGE, NJ 07052-6216
(201) 615-1687
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36422
NJ
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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