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General NPI Number Information
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NPI Number | 1316366685
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Entity Type | Individual
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Provider Name | TALIA DANESHA STEPHENS BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 1501 S NEW RD
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City | PLEASANTVILLE
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State | NJ
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Zip | 08232-3765
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Country | US
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Telephone | 609-380-1122
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Fax | 96-374-9166
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Provider Business Mailing Address
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Address Line | 125 DELAWARE AVE
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234-5796
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Country | US
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Telephone | 609-402-2720
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Fax | 609-788-3617
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1-18-30938
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License Number State |
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