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General NPI Number Information
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NPI Number | 1003623828
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Entity Type | Organization
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Legal Business Name | GUIDED GROWTH ABA NJ
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 49 WATERVIEW DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4312
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Country | US
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Telephone | 323-241-2919
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Fax |
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Provider Business Mailing Address
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Address Line | 49 WATERVIEW DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4312
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Country | US
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Telephone | 323-241-2919
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | MRS. SORA FAIGA ENOCK
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Credential |
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Telephone | 732-674-9863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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