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Organization
MONMOUTH BEHAVIORAL THERAPY GROUP, LLC
Active
Organization
MONMOUTH BEHAVIORAL THERAPY GROUP, LLC
Active
Other names
aBA with TLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA NICOLAS (OWNER)
(732) 687-2418
Entity
Organization
Contact information
Practice address
43 W FRONT ST STE 17, RED BANK, NJ 07701-1600
(732) 784-7501
(732) 383-5844
Mailing address
54 BROAD ST # L-102, RED BANK, NJ 07701-1943
(732) 687-2418
(732) 383-5844
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0400352192
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400352192
STATE OF NEW JERSEY DEPT. OF THE TREASURY CERTIFICATION
NJ
Enumeration date
07/16/2010
Last updated
04/04/2023
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