Healthcare Provider Details

I. General information

NPI: 1215851977
Provider Name (Legal Business Name): HOLLY BUCK BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 BLACK HORSE LANE
MONMOUTH JUNCTION NJ
08852
US

IV. Provider business mailing address

321 BLACK HORSE LANE
MONMOUTH JUNCTION NJ
08852
US

V. Phone/Fax

Practice location:
  • Phone: 732-297-7800
  • Fax:
Mailing address:
  • Phone: 732-297-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12476397
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: