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General NPI Number Information
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NPI Number | 1710648241
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Entity Type | Organization
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Legal Business Name | MY CHILD ABA PLLC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 1105 E COUNTY LINE RD STE 213
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2122
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Country | US
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Telephone | 732-399-9700
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Fax | 516-308-2981
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Provider Business Mailing Address
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Address Line | 1105 E COUNTY LINE RD STE 213
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHELDON KATZ
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Credential |
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Telephone | 646-510-3791
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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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