Individual
KATHERINE DECOTIIS WIEDEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, BCBA
Contact information
Practice address
235 BIRCHWOOD AVE APT 105, CRANFORD, NJ 07016-2544
(973) 229-4911
Mailing address
235 BIRCHWOOD AVE APT 105, CRANFORD, NJ 07016-2544
(973) 229-4911
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-9474
NJ
Other
Enumeration date
02/27/2012
Last updated
08/22/2023
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