Individual
ROBERT SHAUN DEGRAFFENREID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
428 S BROAD ST APT A5, ELIZABETH, NJ 07202-3538
(862) 216-1193
Mailing address
428 S BROAD ST APT A5, ELIZABETH, NJ 07202-3538
(862) 216-1193
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-50310
NJ
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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