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1821642141
STACEY LYNN GORMAN
LAKEWOOD, NJ
NPI
1821642141
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Former Name
STACEY LYNN FENNIMORE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: NJ 1-15-21092)
Enumeration Date
2019-07-25
Last Update Date
2019-07-25
Business Address
STACEY LYNN GORMAN BCBA
2 ESTHER CT
LAKEWOOD, NJ 08701-2946
Phone number: 732-523-1245
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Mailing Address
STACEY LYNN GORMAN BCBA
2 ESTHER CT
LAKEWOOD, NJ 08701-2946
Phone number: 732-523-1245
Copy
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