Individual
ILENE MARACALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 CRAWFORD PL STE 100, MOUNT LAUREL, NJ 08054-3948
(856) 628-1686
Mailing address
1000 CRAWFORD PL STE 100, MOUNT LAUREL, NJ 08054-3948
(856) 628-1686
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-45498
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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