Organization
AUTISM SERVICES GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA BOUSSOM BCBA (CLINICAL MANAGEMENT DIRECTOR)
(609) 454-4598
Entity
Organization
Contact information
Practice address
200 PRINCETON SOUTH CORPORATE CTR, SUITE 260, EWING, NJ 08628-3434
(609) 454-4598
(609) 454-4599
Mailing address
200 PRINCETON SOUTH CORPORATE CENTER, SUITE 260, EWING, NJ 08628-3435
(609) 454-4598
(609) 454-4599
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/22/2011
Last updated
05/17/2012
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