Individual
MR. KENNETH MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 VAN NESS TER APT 3, MAPLEWOOD, NJ 07040-3324
(732) 822-7734
Mailing address
21 VAN NESS TER APT 3, MAPLEWOOD, NJ 07040-3324
(732) 822-7734
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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