Healthcare Provider Details

I. General information

NPI: 1578918371
Provider Name (Legal Business Name): GEORGIA EFTHIMIOU M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WILLOW BROOK RD STE 300
FREEHOLD NJ
07728-5920
US

IV. Provider business mailing address

542 AMHERST ST STE B
NASHUA NH
03063-1016
US

V. Phone/Fax

Practice location:
  • Phone: 908-499-3830
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-9912
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00069200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: