Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003416280 |
---|---|
Provider Name | Moyanda Pierre |
First Address | Orange, NJ 07050-1908 |
Second Address | Edison, NJ 08837-2429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2020 |
Last Update Date | 28/10/2020 |