| NPI | 1760912034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAPHAEL MILLER Director 848-299-2274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 174400000X Specialist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |