Organization
FUNCTIONAL DEVELOPMENT LICENSED BEHAVIORAL ANALYST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GANNA BARTASHEVA (OWNER)
(718) 415-9046
Entity
Organization
Contact information
Practice address
4 MUNCEE CT, HOLMDEL, NJ 07733-1246
(718) 415-9046
Mailing address
4 MUNCEE CT, HOLMDEL, NJ 07733-1246
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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