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General NPI Number Information
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NPI Number | 1629589650
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Entity Type | Organization
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Legal Business Name | SOCIAL BEHAVIOR LEARNING SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 18 MICROLAB RD STE 3
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1640
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Country | US
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Telephone | 862-253-3109
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Fax | 862-520-3027
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Provider Business Mailing Address
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Address Line | 18 MICROLAB RD STE 3
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1640
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Country | US
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Telephone | 862-253-3109
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Fax | 862-520-3027
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Authorized Official
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Title or Position | OWNER/ DIRECTOR
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Name | MS. NANDI NELSON
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Credential | LCSW, BCBA
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Telephone | 862-253-3109
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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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