| NPI | 1720578834 |
|---|---|
| Former Legal Business Name | MR. |
| Entity Type | Organization |
| Authorized Contact | SEAN NUSSBAUM Owner 732-930-1255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 1041S0200X Social Worker School | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2019-04-10 |