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General NPI Number Information
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NPI Number | 1285331868
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Entity Type | Organization
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Legal Business Name | CHARTER BEHAVIOR MANAGEMENT PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 254 CHAPMAN RD STE 112
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City | NEWARK
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State | DE
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Zip | 19702-5413
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Country | US
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Telephone | 215-510-8841
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Fax |
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Provider Business Mailing Address
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Address Line | 185 W CHESTNUT HILL RD
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City | NEWARK
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State | DE
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Zip | 19713-2223
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Country | US
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Telephone | 215-510-8841
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | ALIA BONNER EL
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Credential | M.ED BCBA LBS
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Telephone | 215-510-8841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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