Individual
BASYA SHAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 VILLAGE PATH, LAKEWOOD, NJ 08701-2578
(917) 436-7699
Mailing address
125 VILLAGE PATH, LAKEWOOD, NJ 08701-2578
(917) 436-7699
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12155318
NJ
Other
Enumeration date
11/25/2021
Last updated
11/25/2021
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