MEDICARE: DAILY PRACTICE LLC

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1689057077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAILY PRACTICE LLC

Provider Business Mailing Address
First Line	:	126 E TENNESSEE AVE
Second Line	:
City	:	LONG BEACH TOWNSHIP
State	:	NJ
Zip	:	08008-3065
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 E TENNESSEE AVE
Second Line	:
City	:	LONG BEACH TOWNSHIP
State	:	NJ
Zip	:	08008-3065
Country	:	US
Telephone Number	:	732-978-4856
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KIMBERLY SCLAROW
Credential	:	MA, BCBA
Telephone Number	:	732-978-4856

Provider Enumeration Date	:	07/02/2015
Last Update Date	:	07/08/2015

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Directions to “DAILY PRACTICE LLC ” Practice Location

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