Organization
INTELLISTARS ABA AZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM GREENWALD MSED (CHIEF CARING OFFICER)
(470) 704-5219
Entity
Organization
Contact information
Practice address
2 N CENTRAL AVE STE 1800, PHOENIX, AZ 85004-2139
(470) 704-5219
Mailing address
1980 SWARTHMORE AVE UNIT 1, LAKEWOOD, NJ 08701-4765
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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