Individual
NATHAN HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9802 NICHOLAS ST STE 395, OMAHA, NE 68114-2168
(732) 806-0091
Mailing address
311 BOULEVARD OF THE AMERICAS, STE 304, LAKEWOOD, NJ 08701
(732) 806-0091
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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