Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | BACB530013 |
NPI | 1922630565 |
---|---|
Provider Name | Ms. Diane J Strickland |
First Address | East Orange, NJ 07017-2789 |
Second Address | Lyndhurst, NJ 07071-2620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2020 |
Last Update Date | 11/02/2020 |