Healthcare Provider Details

I. General information

NPI: 1932961448
Provider Name (Legal Business Name): NEURABILITIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 RIVER BANK DR
ROEBLING NJ
08554-1527
US

IV. Provider business mailing address

129 RIVER BANK DR
ROEBLING NJ
08554-1527
US

V. Phone/Fax

Practice location:
  • Phone: 609-479-1975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: NICOLE DUDLEY
Title or Position: CHIEF CLINICAL OFFICER
Credential: BCBA
Phone: 347-406-0725