Provider Demographics
NPI:1003623828
Name:GUIDED GROWTH ABA NJ
Entity type:Organization
Organization Name:GUIDED GROWTH ABA NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:SORA
Authorized Official - Middle Name:FAIGA
Authorized Official - Last Name:ENOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-674-9863
Mailing Address - Street 1:49 WATERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4312
Mailing Address - Country:US
Mailing Address - Phone:323-241-2919
Mailing Address - Fax:
Practice Address - Street 1:49 WATERVIEW DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4312
Practice Address - Country:US
Practice Address - Phone:323-241-2919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst