Organization
SUPER SPROUTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALKA BIRNBAUM MS ED BCBA LBA (MANAGER/OWNER)
(347) 522-6032
Entity
Organization
Contact information
Practice address
1039 E 23RD ST # 1010, FREMONT, NE 68025-2448
(347) 522-6032
Mailing address
23 HOLDEN SQ, LAKEWOOD, NJ 08701-5828
(347) 522-6032
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/04/2025
Last updated
04/30/2026
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