| Progressive Trends Llc | |
|
109 Beagle Dr Manalapan NJ 07726-8818 | |
| (732) 713-4995 | |
| (732) 605-0568 |
| Full Name | Progressive Trends Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 109 Beagle Dr, Manalapan, New Jersey |
| Authorized Official Name and Position | Stacey Liebross (S & L THERAPIST AND BCBA) |
| Authorized Official Contact | 7327134995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Trends Llc 109 Beagle Dr Manalapan NJ 07726-8818 Ph: (732) 713-4995 | Progressive Trends Llc 109 Beagle Dr Manalapan NJ 07726-8818 Ph: (732) 713-4995 |
| NPI Number | 1912587189 |
|---|---|
| Provider Enumeration Date | 04/12/2021 |
| Last Update Date | 04/12/2021 |
| Certification Date | 03/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912587189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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