Individual
TAKEESHA DANIELLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 POWELL ST, GLOUCESTER CITY, NJ 08030-2045
(609) 922-8861
Mailing address
705 POWELL ST, GLOUCESTER CITY, NJ 08030-2045
(609) 922-8861
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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