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NPI Code Detail

MEDICARE: FLOURISHING MINDS ABA

MEDICARE: FLOURISHING MINDS ABA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1588363188
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLOURISHING MINDS ABA
Provider Business Mailing Address
First Line : 4 S ORANGE AVE # 285
Second Line :
City : SOUTH ORANGE
State : NJ
Zip : 07079-1702
Country : US
Telephone Number : 862-250-4542
Fax Number :
Provider Business Practice Location Address
First Line : 1557 SPRINGFIELD AVE
Second Line :
City : MAPLEWOOD
State : NJ
Zip : 07040-2413
Country : US
Telephone Number : 862-250-4542
Fax Number :
Authorized Official
Title or Position : BOARD CERTIFIED BEHAVIOR ANALYST
Name : LUZ C JEAN
Credential : BCBA
Telephone Number : 862-250-4542
Provider Enumeration Date : 03/02/2023
Last Update Date : 03/02/2023

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Directions to “FLOURISHING MINDS ABA ” Practice Location

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