Provider Demographics
NPI:1083917892
Name:GROWING TOGETHER
Entity Type:Organization
Organization Name:GROWING TOGETHER
Other - Org Name:LEARNING TOGETHER THERAPEUTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:ABA BEHAVIORAL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PETITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-356-5363
Mailing Address - Street 1:14 WORLDS FAIR DRIVE
Mailing Address - Street 2:STE M
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-356-5363
Mailing Address - Fax:
Practice Address - Street 1:14 WORLDS FAIR DRIVE
Practice Address - Street 2:STE M
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-356-5363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty