| NPI | 1407510852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN THOMAS Biller 201-241-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2024-05-29 |