| Shining Minds Llc | |
|
1 Stone Ave Elmwood Park NJ 07407-1150 | |
| (973) 572-4216 | |
| Not Available |
| Full Name | Shining Minds Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1 Stone Ave, Elmwood Park, New Jersey |
| Authorized Official Name and Position | Angelina Marie Longo (BOARD CERTIFIED BEHAVIOR ANALYST) |
| Authorized Official Contact | 9736472745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shining Minds Llc 132 Hollywood Ave Fairfield NJ 07004-1223 Ph: (973) 647-2745 | Shining Minds Llc 1 Stone Ave Elmwood Park NJ 07407-1150 Ph: (973) 572-4216 |
| NPI Number | 1831843473 |
|---|---|
| Provider Enumeration Date | 02/11/2022 |
| Last Update Date | 02/11/2022 |
| Certification Date | 02/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831843473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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