Provider Demographics
NPI:1588030589
Name:1 OF A KIND ABA AND SPEECH THERAPY
Entity Type:Organization
Organization Name:1 OF A KIND ABA AND SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GIGANTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-266-6119
Mailing Address - Street 1:9 NETHERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4033
Mailing Address - Country:US
Mailing Address - Phone:732-266-6119
Mailing Address - Fax:
Practice Address - Street 1:9 NETHERWOOD AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4033
Practice Address - Country:US
Practice Address - Phone:732-266-6119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NJBACB235681103K00000X
NJ103K00000X
NJ41YS00730300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty