Healthcare Provider Details

I. General information

NPI: 1992370811
Provider Name (Legal Business Name): CHRISTINE ELIZABETH VENEZIALE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE ELIZABETH YOUNG

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 WEST ASHLAND STREET
DOYLESTOWN PA
18901-4040
US

IV. Provider business mailing address

2468 SCHAFFER RD
POTTSTOWN PA
19464-1116
US

V. Phone/Fax

Practice location:
  • Phone: 215-479-3798
  • Fax:
Mailing address:
  • Phone: 215-479-3798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH003036
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: