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NPI 1174325682

NPI 1174325682 : SCAFFOLD ABA : LAKEWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1174325682
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    Entity Type          |    Organization 
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    Legal Business Name  |    SCAFFOLD ABA 
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Dates
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    Enumeration Date     |    03/25/2025
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    Last Update Date     |    03/25/2025
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Provider Practice Location Address
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    Address Line         |    70 ROSEWOOD DR 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-5777
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    Country              |    US
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    Telephone            |    862-668-0772
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    70 ROSEWOOD DR 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-5777
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    Country              |    US
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    Telephone            |    862-668-0772
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     GALIA E FEIGENBAUM 
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    Credential           |    BCBA
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    Telephone            |    862-668-0772
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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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