Organization
ADVANCED THERAPY OF AMERICA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA DIANE MCNISH M.S. CCC-SLP (CEO)
(732) 726-0600
Entity
Organization
Contact information
Practice address
485A US HIGHWAY 1 S, SUITE 300, ISELIN, NJ 08830-3012
(732) 726-0600
Mailing address
485A US HIGHWAY 1 S, SUITE 300, ISELIN, NJ 08830-3012
(732) 726-0600
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0031052
NJ
225X00000X
Occupational Therapist
46TR00305400
NJ
225X00000X
Occupational Therapist
46TR00323600
NJ
235Z00000X
Speech-Language Pathologist
41YS00374500
NJ
235Z00000X
Speech-Language Pathologist
Primary
41YS00422600
NJ
235Z00000X
Speech-Language Pathologist
41YS00452100
NJ
Other
Enumeration date
05/09/2012
Last updated
09/30/2014
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