Provider Demographics
NPI:1164982492
Name:CHALKER, BRIDGET (BCBA)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:CHALKER
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 1:5 OCEAN ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2215
Mailing Address - Country:US
Mailing Address - Phone:617-905-8838
Mailing Address - Fax:
Practice Address - Street 1:5 OCEAN ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2215
Practice Address - Country:US
Practice Address - Phone:617-905-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2623103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst