Individual
REBECCA O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
329 AYCRIGG AVE, PASSAIC, NJ 07055-3713
(973) 471-3046
Mailing address
110 MIDLAND AVE, GLEN RIDGE, NJ 07028-2045
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-41275
BACB
NJ
Enumeration date
02/10/2022
Last updated
02/10/2022
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