Organization
INNOVATIVE IDEAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAMALATHARA SRIKANTH BCBA (CLINICAL DIRECTOR)
(609) 721-2227
Entity
Organization
Contact information
Practice address
12 VAN GOGH DR, EAST WINDSOR, NJ 08520-2999
(609) 721-2227
Mailing address
12 VAN GOGH DR, EAST WINDSOR, NJ 08520-2999
(609) 721-2227
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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