Individual provider · NPI-1
Ebony Copeland
Behavior Technician · Newark, NJ
NPI number1114656188
StatusActive
Last updated in NPPESJun 6, 2022
Details
- NPI
- 1114656188
- Entity type
- Individual (NPI-1)
- Name
- Ebony Copeland
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 6, 2022
- Certification date
- Jun 6, 2022
- Last updated
- Jun 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | NJ | Yes |
Practice location
549b S 19th StNewark, NJ 07103-1386
Phone 862-944-0593
Mailing address
Po Box 2104East Orange, NJ 07019-2104
Phone 862-944-0593
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