Wild, Ethan

Wild, Ethan is an individual health care provider with primary practice located at 43 Elizabeth St , Pemberton NJ 08068-1232. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Wild, Ethan can be contacted via phone (609) 316-0195.

Contact Information

Primary practice address
43 Elizabeth St Pemberton NJ 08068-1232
Phone: (609) 316-0195
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-20-126237 New Jersey

Profile Details

NPI number 1649898057
LBN Legal business name Wild, Ethan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2020
Last updated Jul 13th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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