| NPI | 1689545071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA RADER Director 848-350-5973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-10-13 |