Individual
MARY FEDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
267 CHAMONE AVE, LEONARDO, NJ 07737-1702
(908) 675-3681
Mailing address
267 CHAMONE AVE, LEONARDO, NJ 07737-1702
(908) 675-3681
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IDK
IDK
—
Enumeration date
06/09/2021
Last updated
06/09/2021
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