Organization
MONMOUTH BEHAVIORAL THERAPY GROUP, LLC
Active
Other names
aBA with TLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA NICOLAS (OWNER)
(732) 687-2418
Entity
Organization
Contact information
Practice address
43 W FRONT ST STE 17, RED BANK, NJ 07701-1600
(732) 784-7501
(732) 383-5844
Mailing address
54 BROAD ST # L-102, RED BANK, NJ 07701-1943
(732) 687-2418
(732) 383-5844
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0400352192
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400352192
STATE OF NEW JERSEY DEPT. OF THE TREASURY CERTIFICATION
NJ
Enumeration date
07/16/2010
Last updated
04/04/2023
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