Provider Demographics
NPI:1578217584
Name:MAKING WAVES ABA
Entity Type:Organization
Organization Name:MAKING WAVES ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:856-625-6975
Mailing Address - Street 1:108 N ROSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-2020
Mailing Address - Country:US
Mailing Address - Phone:856-625-6975
Mailing Address - Fax:
Practice Address - Street 1:108 N ROSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:VENTNOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08406-2020
Practice Address - Country:US
Practice Address - Phone:856-625-6975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty