Healthcare Provider Details
I. General information
NPI: 1184339863
Provider Name (Legal Business Name): DAAS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 KINGSFIELD DR
LAKEWOOD NJ
08701-3274
US
IV. Provider business mailing address
100 KINGSFIELD DR
LAKEWOOD NJ
08701-3274
US
V. Phone/Fax
- Phone: 732-749-0733
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NOHUM
MONOSOV
Title or Position: CEO
Credential: MS ED BCBA
Phone: 732-749-0733