Individual
MICHAEL JESSE MIZRAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
500 S LAKE DR, LAKEWOOD, NJ 08701-3169
(718) 755-6868
Mailing address
500 S LAKE DR, LAKEWOOD, NJ 08701-3169
(718) 755-6868
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79197
—
103K00000X
Behavior Analyst
Primary
15BC00135900
NJ
Other
Enumeration date
02/17/2025
Last updated
05/01/2026
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