| NPI | 1154871671 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DANIELLA SIMON Owner 732-213-1006 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801096395) | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-14-15924) | 
| Enumeration Date | 2016-10-07 | 
| Last Update Date | 2016-10-07 |