Healthcare Provider Details

I. General information

NPI: 1588098396
Provider Name (Legal Business Name): MIRIAM GOLDIE TWERSKI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MIDTOWN CIR
LAKEWOOD NJ
08701-7604
US

IV. Provider business mailing address

1 MIDTOWN CIR STE 1
LAKEWOOD NJ
08701-7604
US

V. Phone/Fax

Practice location:
  • Phone: 732-833-3723
  • Fax: 888-247-4390
Mailing address:
  • Phone: 732-833-3723
  • Fax: 888-247-4390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: