Individual
MEGAN ELIZABETH DOMZALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
5 RAVEN LN, LAKEWOOD, NJ 08701-4968
(732) 730-0700
Mailing address
100 WARREN ST, JERSEY CITY, NJ 07302-6406
(908) 268-9279
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27664
—
Other
Enumeration date
12/20/2017
Last updated
03/17/2018
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