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NPI Code Detail

MEDICARE: STACY ADIEZE BCBA

MEDICARE: STACY ADIEZE BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1457921769
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY ADIEZE BCBA
Provider Business Mailing Address
First Line : 523 1ST AVE
Second Line :
City : BELLMAWR
State : NJ
Zip : 08031-1410
Country : US
Telephone Number : 856-693-6146
Fax Number :
Provider Business Practice Location Address
First Line : 4 MILL RUN CT
Second Line :
City : MEDFORD
State : NJ
Zip : 08055-2436
Country : US
Telephone Number : 609-440-5792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2021
Last Update Date : 06/10/2025

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Directions to “ STACY ADIEZE BCBA” Practice Location

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