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General NPI Number Information
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NPI Number | 1194329284
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Entity Type | Individual
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Provider Name | LISA MARIE PIRRELLO BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 1075 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1648
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Country | US
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Telephone | 973-703-9591
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Fax |
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Provider Business Mailing Address
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Address Line | 23 JAMES ST
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677-8017
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Country | US
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Telephone | 201-706-0971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-44428
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License Number State | NJ
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