Organization
INTELLISTARS ABA TN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM GREENWALD MSED (CHIEF CARING OFFICER)
(732) 597-3699
Entity
Organization
Contact information
Practice address
6000 POPLAR AVE STE 250, MEMPHIS, TN 38119-3974
(248) 770-3658
Mailing address
311 BOULEVARD OF AMERICAS STE 109, LAKEWOOD, NJ 08701-4788
(248) 770-3658
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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