Healthcare Provider Details

I. General information

NPI: 1841778016
Provider Name (Legal Business Name): VANESSA VANDERSLICE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VANESSA VANDERSLICE BCBA

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE B
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE B
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 832-562-8461
  • Fax:
Mailing address:
  • Phone: 302-367-7105
  • Fax: 302-268-6942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: