Provider Demographics
NPI:1669033882
Name:WINGS ABA THERAPY LLC
Entity Type:Organization
Organization Name:WINGS ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-603-2277
Mailing Address - Street 1:223 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3132
Mailing Address - Country:US
Mailing Address - Phone:201-603-2277
Mailing Address - Fax:
Practice Address - Street 1:223 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3132
Practice Address - Country:US
Practice Address - Phone:201-603-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty