Individual
MIKAELA EMILY GRANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
331 DORN AVE, MIDDLESEX, NJ 08846
(732) 339-3100
Mailing address
331 DORN AVE, MIDDLESEX, NJ 08846-1117
(732) 339-3100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44743
NJ
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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