Individual
PEPUKAYI WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDT-C
Contact information
Practice address
455 COLONIAL TER, HACKENSACK, NJ 07601-1403
(201) 996-9264
Mailing address
164 CLINTON PL APT 1E, HACKENSACK, NJ 07601-4653
(201) 952-6631
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
235716
NJ
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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