| NPI | 1972270338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN THOMAS Biller/Credentialer 201-241-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2024-05-29 |