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General NPI Number Information
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NPI Number | 1659006153
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Entity Type | Individual
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Provider Name | PATRICE ROBERTS BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 331 HOOPER ST
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City | SOMERSET
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State | NJ
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Zip | 08873-2591
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Country | US
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Telephone | 973-800-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 MONROE DR
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City | STEWARTSVILLE
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State | NJ
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Zip | 08886-2633
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Country | US
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Telephone | 973-800-3733
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Fax |
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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 | 1-22-59747
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License Number State | NJ
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