Healthcare Provider Details

I. General information

NPI: 1841653649
Provider Name (Legal Business Name): REBEKAH ROSE VLADICK M.ED. BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 SIOUX AVE
OAKLAND NJ
07436-2133
US

IV. Provider business mailing address

42 SIOUX AVE
OAKLAND NJ
07436-2133
US

V. Phone/Fax

Practice location:
  • Phone: 845-527-1621
  • Fax:
Mailing address:
  • Phone: 845-527-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: