Provider Demographics
NPI:1245797778
Name:BAUGH, BERNARD (BCBA)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:
Last Name:BAUGH
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CRAWFORD PL STE 260
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3965
Mailing Address - Country:US
Mailing Address - Phone:856-689-1799
Mailing Address - Fax:480-393-4069
Practice Address - Street 1:1000 CRAWFORD PL STE 260
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3965
Practice Address - Country:US
Practice Address - Phone:856-689-1799
Practice Address - Fax:480-393-4069
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-18036103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst