Individual
MICHAEL FENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
62 BRADLEY AVE, BERGENFIELD, NJ 07621-2108
(201) 925-8128
Mailing address
62 BRADLEY AVE, BERGENFIELD, NJ 07621-2108
(201) 925-8128
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-6640
NJ
Other
Enumeration date
06/29/2023
Last updated
07/18/2023
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