Individual
MIRIAM BRACHA GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 CLIFTON AVE, LAKEWOOD, NJ 08701-1844
(732) 364-6307
Mailing address
1447 OAK ST, LAKEWOOD, NJ 08701-5427
(732) 364-6307
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27020
NJ
174400000X
Specialist
—
—
Other
Enumeration date
10/25/2012
Last updated
10/06/2022
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