Healthcare Provider Details

I. General information

NPI: 1982509139
Provider Name (Legal Business Name): BRIELLE ROSE SPERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 OLD RTE 518 W
LAMBERTVILLE NJ
08530-2617
US

IV. Provider business mailing address

6 OLD RTE 518 W
LAMBERTVILLE NJ
08530-2617
US

V. Phone/Fax

Practice location:
  • Phone: 609-577-1539
  • Fax:
Mailing address:
  • Phone: 609-577-1539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00133500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: