Organization
GREAT MINDS ABA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTEN THOMSEN BCBA (BEHAVIOR ANALYST/DIRECTOR)
(856) 220-9903
Entity
Organization
Contact information
Practice address
4 WHITNEY PL, HAINESPORT, NJ 08036-6251
(856) 220-9903
Mailing address
4 WHITNEY PL, HAINESPORT, NJ 08036-6251
(856) 220-9903
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-27369
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
10/08/2019
Last updated
10/08/2019
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