Healthcare Provider Details

I. General information

NPI: 1053801746
Provider Name (Legal Business Name): DANIELLE S. JEUDY PHD, BCBA-D, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 HIGH ST UNIT 1432
BURLINGTON NJ
08016-4565
US

IV. Provider business mailing address

427 HIGH ST UNIT 1432
BURLINGTON NJ
08016-4565
US

V. Phone/Fax

Practice location:
  • Phone: 908-487-4545
  • Fax:
Mailing address:
  • Phone: 908-487-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-29545
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: