Provider Demographics
NPI:1326371741
Name:DEBERY, GEOFFREY (BCBA)
Entity Type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:
Last Name:DEBERY
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 1:443 17TH ST
Mailing Address - Street 2:APT 1L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6233
Mailing Address - Country:US
Mailing Address - Phone:215-495-2411
Mailing Address - Fax:
Practice Address - Street 1:443 17TH ST
Practice Address - Street 2:APT 1L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6233
Practice Address - Country:US
Practice Address - Phone:215-495-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst