Provider Demographics
NPI:1346645397
Name:FONTANA, ANDREA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:FONTANA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:YEAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:20 GREAVES PL
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-1839
Mailing Address - Country:US
Mailing Address - Phone:908-858-2224
Mailing Address - Fax:
Practice Address - Street 1:20 GREAVES PL
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-1839
Practice Address - Country:US
Practice Address - Phone:908-858-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-01
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst