Organization
BRAVE WINGS ACADEMY, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOORE EDD, BCBA (CO-OWNER)
(973) 800-8515
Entity
Organization
Contact information
Practice address
155 PASSAIC AVE STE 150, FAIRFIELD, NJ 07004-3562
(973) 800-8515
Mailing address
155 PASSAIC AVE STE 150, FAIRFIELD, NJ 07004-3562
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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