| NPI | 1598552580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN THIEL Board Certified Behavior Analyst 732-664-0577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-04-22 |