Provider Demographics
NPI:1043671076
Name:D'AMELIO, CRISTINA (BCBA)
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:
Last Name:D'AMELIO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 GREEN LN
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-1823
Mailing Address - Country:US
Mailing Address - Phone:856-906-7984
Mailing Address - Fax:
Practice Address - Street 1:431 GREEN LN
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:NJ
Practice Address - Zip Code:08051-1823
Practice Address - Country:US
Practice Address - Phone:856-906-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-15-18159103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst