Provider Demographics
NPI:1346954484
Name:GALLAGHER, CARA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TENAFLY RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-7000
Mailing Address - Country:US
Mailing Address - Phone:201-777-4557
Mailing Address - Fax:
Practice Address - Street 1:400 TENAFLY RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-7000
Practice Address - Country:US
Practice Address - Phone:201-777-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-21-55429103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst