Provider Demographics
NPI:1083927669
Name:SCLAROW, KIMBERLY KAMHI (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAMHI
Last Name:SCLAROW
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:SCLAROW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:201 ROLLING MEADOWS BLVD N
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-8557
Mailing Address - Country:US
Mailing Address - Phone:732-832-1340
Mailing Address - Fax:
Practice Address - Street 1:126 E TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08008-3065
Practice Address - Country:US
Practice Address - Phone:732-832-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-06-3093103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst