Provider Demographics
NPI:1669015293
Name:DOMANSKI ABA SERVICES
Entity Type:Organization
Organization Name:DOMANSKI ABA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:908-812-0766
Mailing Address - Street 1:102 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1017
Mailing Address - Country:US
Mailing Address - Phone:908-812-0766
Mailing Address - Fax:
Practice Address - Street 1:102 CENTER AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1017
Practice Address - Country:US
Practice Address - Phone:908-812-0766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-27
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty