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General NPI Number Information
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NPI Number | 1750779161
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Entity Type | Individual
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Provider Name | CHARLES KNOPPEL III BCBA
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Gender | Male
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 2432 BROOKHAVEN DR
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City | VINELAND
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State | NJ
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Zip | 08361-6850
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Country | US
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Telephone | 732-691-1299
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Fax |
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Provider Business Mailing Address
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Address Line | 4402 NATURES REACH TER
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City | PARRISH
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State | FL
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Zip | 34219-1231
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Country | US
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Telephone |
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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 | 1-14-17083
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License Number State | FL
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