Organization
EMPOWER LICENSED BEHAVIOR ANALYST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERI E GOLDWURM BA (CEO)
(718) 702-7693
Entity
Organization
Contact information
Practice address
5213 19TH AVE, BROOKLYN, NY 11204-1602
(718) 702-7693
(718) 387-6429
Mailing address
5213 19TH AVE, BROOKLYN, NY 11204-1602
(718) 702-7693
(718) 387-6429
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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