Healthcare Provider Details

I. General information

NPI: 1487590121
Provider Name (Legal Business Name): EMILY GRACE CHALBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SOMERSTOWN LN
GALLOWAY NJ
08205-6016
US

IV. Provider business mailing address

535 COVINGTON TER
MOORESTOWN NJ
08057-1634
US

V. Phone/Fax

Practice location:
  • Phone: 609-218-8664
  • Fax: 703-348-3267
Mailing address:
  • Phone: 856-266-2647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: