| Kids Club Aba | |
|
289 S Culver St Lawrenceville GA 30046-4805 | |
| (973) 294-8815 | |
| Not Available |
| Full Name | Kids Club Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 289 S Culver St, Lawrenceville, Georgia |
| Authorized Official Name and Position | Moshe Bobker (MANAGER) |
| Authorized Official Contact | 9732948815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Club Aba 400 Rella Blvd Ste 165 Suffern NY 10901-8114 Ph: (973) 294-8815 | Kids Club Aba 289 S Culver St Lawrenceville GA 30046-4805 Ph: (973) 294-8815 |
| NPI Number | 1902679772 |
|---|---|
| Provider Enumeration Date | 11/03/2023 |
| Last Update Date | 05/13/2024 |
| Certification Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902679772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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