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General NPI Number Information
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NPI Number | 1144552621
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Entity Type | Organization
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Legal Business Name | BRAINBUILDERS
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 945 RIVER AVE SUITE 201
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5606
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Country | US
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Telephone | 732-833-3723
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Fax | 888-247-4390
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Provider Business Mailing Address
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Address Line | 945 RIVER AVE SUITE 201
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5606
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Country | US
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Telephone | 732-833-3723
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Fax | 888-247-4390
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. RACHEL SOROTZKIN
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Credential | BCBA
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Telephone | 732-883-3723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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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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