| Holistic Brain Center | |
|
114 Broughton Ave Bloomfield NJ 07003-3989 | |
| (973) 932-0178 | |
| Not Available |
| Full Name | Holistic Brain Center |
|---|---|
| Speciality | Behavior Analyst |
| Location | 114 Broughton Ave, Bloomfield, New Jersey |
| Authorized Official Name and Position | Latrel Dortch (OWNER) |
| Authorized Official Contact | 9739320178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Brain Center 114 Broughton Ave Bloomfield NJ 07003-3989 Ph: (973) 932-0178 | Holistic Brain Center 114 Broughton Ave Bloomfield NJ 07003-3989 Ph: (973) 932-0178 |
| NPI Number | 1851210363 |
|---|---|
| Provider Enumeration Date | 07/10/2026 |
| Last Update Date | 07/10/2026 |
| Certification Date | 07/10/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851210363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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