Provider Demographics
NPI:1598482739
Name:ADORE, DESIREE MARIE (MA, BCBA, NCC, BSL-P)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:MARIE
Last Name:ADORE
Suffix:
Gender:F
Credentials:MA, BCBA, NCC, BSL-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 PONTIAC RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4817
Mailing Address - Country:US
Mailing Address - Phone:484-975-0680
Mailing Address - Fax:
Practice Address - Street 1:1072 PONTIAC RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4817
Practice Address - Country:US
Practice Address - Phone:484-975-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003439103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst