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General NPI Number Information
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NPI Number | 1942093356
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Entity Type | Individual
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Provider Name | ELENA COULDREY EDD, BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 395 ROUTE 70 STE 202
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City | LAKEWOOD
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State | NJ
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Zip | 08701-6161
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Country | US
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Telephone | 732-523-2327
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Fax |
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Provider Business Mailing Address
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Address Line | 222 ANTOINETTE CT
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City | BRICK
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State | NJ
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Zip | 08723-6348
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Country | US
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Telephone | 50-213-3422
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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 |
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License Number State |
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