Most Relevant Information
Provider Data
| NPI Number: | 1003672742 |
| Provider Name: | JACQUELINE GONZALEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/21/2024 |
| Last Updated: | 02/21/2024 |
Provider Practice Location
1 DEGRAW AVE
TEANECK
NJ
076664094
Practice Location Phone/Fax
| Phone: | 7188655165 |
| Fax: | 7188655165 |
Provider Mailing Location
1 DEGRAW AVE
TEANECK
NJ
076664094
Provider Mailing Phone/Fax
| Phone: | 7188655165 |
| Fax: | 7188655165 |