Ethan Wild

Behavior Technician · Pemberton, NJ

Individual Active NPI

NPI number 1649898057

Practice location

43 Elizabeth St
Pemberton, NJ 08068-1232
Phone
(609) 316-0195

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NPI record

NPI
1649898057
Entity type
Individual (Type 1)
Enumeration date
July 13, 2020
Last updated
July 13, 2020
Certified
July 13, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Technician Primary 106S00000X RBT-20-126237 NJ

Mailing address

PO Box 253
Skillman, NJ 08558-0253

About Ethan Wild

Ethan Wild is a healthcare provider registered in the NPI registry with the primary taxonomy Behavior Technician (code 106S00000X). The practice location is 43 Elizabeth St, Pemberton, NJ 08068-1232. The NPI number 1649898057 was assigned on July 13, 2020 and the record was last updated on July 13, 2020.

Ethan Wild lists a license in the registry: #RBT-20-126237 (NJ) for Behavior Technician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ethan Wild?

The NPI number is 1649898057.

What is the phone number of Ethan Wild?

The phone number listed for the practice location is (609) 316-0195.

Where is Ethan Wild located?

43 Elizabeth St, Pemberton, NJ 08068-1232.

What is the taxonomy code for Ethan Wild?

The primary taxonomy code is 106S00000X – Behavior Technician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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