Provider Demographics
NPI:1447771753
Name:MORGAN, JACQUELINE (BCBA)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:EGGINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:583 SHOEMAKER RD STE 230
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 BIRCHFIELD DR
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4015
Practice Address - Country:US
Practice Address - Phone:484-681-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1-17-25951OtherBCBA CERTIFICATION