Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-09-5649 | NJ |
NPI | 1013268473 |
---|---|
Provider Name | Mrs. Megan Elizabeth Duffy Cassella |
First Address | Carlstadt, NJ 07072-1843 |
Second Address | Carlstadt, NJ 07072-1843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2012 |
Last Update Date | 26/09/2012 |