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NPI Code Detail

MEDICARE: KELLY DECKER M.A., BCBA

MEDICARE: KELLY DECKER M.A., BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystNJ

General Provider Information

NPI Number : 1881219392
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY DECKER M.A., BCBA
Provider Business Mailing Address
First Line : 1001 BRIGGS RD STE 280
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-4104
Country : US
Telephone Number : 856-955-0811
Fax Number :
Provider Business Practice Location Address
First Line : 1001 BRIGGS RD STE 280
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-4104
Country : US
Telephone Number : 856-955-0811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2020
Last Update Date : 11/01/2023

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Directions to “ KELLY DECKER M.A., BCBA” Practice Location

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