Individual
MRS. GRETHE YACKANIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
28 LIVINGSTON AVE, WARREN, NJ 07059-5743
(609) 529-9578
Mailing address
28 LIVINGSTON AVE, WARREN, NJ 07059-5743
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-15589
NJ
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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