Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-30874 |
NPI | 1003435439 |
---|---|
Provider Name | Robert Slavin |
First Address | Cherry Hill, NJ 08002-0223 |
Second Address | Mount Laurel, NJ 08054-3965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2020 |
Last Update Date | 15/04/2020 |