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General NPI Number Information
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NPI Number | 1457086530
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Entity Type | Organization
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Legal Business Name | BE YOURSELF ABA
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 135 JACKSON RD
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City | MEDFORD
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State | NJ
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Zip | 08055-1127
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Country | US
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Telephone | 640-600-4137
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Fax | 609-543-2600
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Provider Business Mailing Address
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Address Line | 26 ANTIS ST
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City | PEMBERTON
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State | NJ
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Zip | 08068-1127
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Country | US
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Telephone | 267-981-1645
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JESSICA SCHURSTEIN
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Credential | MS, BCBA
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Telephone | 640-600-4137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 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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