Provider Demographics
NPI:1053857896
Name:SCHNEIDER, NICOLA (BCBA)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:
Last Name:SCHNEIDER
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 1:61 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3812
Mailing Address - Country:US
Mailing Address - Phone:201-281-5234
Mailing Address - Fax:
Practice Address - Street 1:61 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-3812
Practice Address - Country:US
Practice Address - Phone:201-281-5234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-10219103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst