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General NPI Number Information
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NPI Number | 1942025796
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Entity Type | Individual
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Provider Name | JILLIAN GALASSO
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 18 MICROLAB RD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1639
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Country | US
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Telephone | 862-253-3109
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Fax |
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Provider Business Mailing Address
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Address Line | 126 BOWFELL CT
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City | WAYNE
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State | NJ
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Zip | 07470-2146
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | NJ
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