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NPI 1609384932 · live from the CMS NPI Registry

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Behavior Analyst in Newark, DE. National Provider Identifier 1609384932, active.

NPI record

NPI1609384932 Type 2 · organization
StatusActive
Primary specialtyBehavior Analyst 103K00000X
Practice location514 Interchange Blvd, Newark, DE 19711
Practice phone302-452-3400
Mailing address49 Broadleaf Dr, Newark, DE 19702
EnumeratedJanuary 22, 2018
Last updatedJanuary 22, 2018
Authorized officialMarc Fields, Behavior Analyst

Taxonomies and licenses

TaxonomyCodeLicense
Behavior Analyst103K00000X1-05-2374 (DE)
Psychologist, Clinical103TC0700XB1-0000651 (DE)
Behavior Analyst primary103K00000XBACB275582 (DE)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.