Provider Demographics
NPI:1912761578
Name:AGBAZA, ESTHER ZINO
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:ZINO
Last Name:AGBAZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KEY AUTISM SERVICES 1385 HWY 35
Mailing Address - Street 2:#284
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748
Mailing Address - Country:US
Mailing Address - Phone:609-227-7130
Mailing Address - Fax:
Practice Address - Street 1:KEY AUTISM SERVICES 1385 HWY 35
Practice Address - Street 2:#284
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748
Practice Address - Country:US
Practice Address - Phone:609-227-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician