Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-54134 | NJ |
NPI | 1003578527 |
---|---|
Provider Name | Jessica Sosnowski |
First Address | Toms River, NJ 08753-3635 |
Second Address | Toms River, NJ 08753-3635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2021 |
Last Update Date | 12/10/2021 |