Individual
VANESSA I GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
381 PASSAIC ST, HACKENSACK, NJ 07601-1575
(973) 405-3632
Mailing address
381 PASSAIC ST, HACKENSACK, NJ 07601-1575
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
G64597626956972
NJ
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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