Individual
MRS. AVIGAIL SOLEIMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,BCBA
Contact information
Practice address
420 ASHLEY AVE, LAKEWOOD, NJ 08701-4865
(917) 412-0082
(732) 370-7621
Mailing address
420 ASHLEY AVE, LAKEWOOD, NJ 08701-4865
(732) 370-7621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28306
NJ
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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