Individual
CARINA VALENCIA VANRYCK DEGROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 BEASLEY ST, WEST ORANGE, NJ 07052-2901
(862) 400-6175
Mailing address
20 BEASLEY ST, WEST ORANGE, NJ 07052-2901
(862) 400-6175
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1575544221
NY
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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