Individual
MS. MICHELLE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.C.B.A.
Contact information
Practice address
1036 WILSON AVE, TEANECK, NJ 07666-1811
(201) 774-8545
Mailing address
1036 WILSON AVE, TEANECK, NJ 07666-1811
(201) 774-8545
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-11-8456
BACB (BEHAVIOR ANALYST CERTIFICATION BOARD)
NJ
Enumeration date
10/26/2011
Last updated
10/26/2011
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