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General NPI Number Information
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NPI Number | 1922787290
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Entity Type | Organization
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Legal Business Name | DISCOVER LICENSED BEHAVIOR ANALYST NJ PC
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 5 BLUE RIVER WAY
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5680
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Country | US
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Telephone | 347-271-0792
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Fax | 718-540-4737
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Provider Business Mailing Address
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Address Line | 1350 55TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-4213
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Country | US
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Telephone | 347-271-0792
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Fax | 718-540-4737
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHAVA NEUMAN
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Credential | BCBA LBA
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Telephone | 347-271-0792
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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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