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General NPI Number Information
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NPI Number | 1932835287
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Entity Type | Organization
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Legal Business Name | BRIGHTER STRIDES ABA MO LLC
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Dates
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Enumeration Date | 07/28/2022
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 4625 LINDELL BLVD STE 2466
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City | SAINT LOUIS
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State | MO
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Zip | 63108-3725
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Country | US
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Telephone | 314-350-3743
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Fax |
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Provider Business Mailing Address
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Address Line | 1777 AVENUE OF THE STATES # 104
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4779
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Country | US
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Telephone | 845-608-2886
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Fax |
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Authorized Official
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Title or Position | HR
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Name | LEWY WOLMARK
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Credential |
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Telephone | 410-609-6357
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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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