Provider Demographics
NPI:1609001197
Name:DARLEY, LOUIS (MS,, BCBA)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:
Last Name:DARLEY
Suffix:
Gender:M
Credentials:MS,, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3803
Mailing Address - Country:US
Mailing Address - Phone:215-342-6121
Mailing Address - Fax:
Practice Address - Street 1:1714 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-3803
Practice Address - Country:US
Practice Address - Phone:215-342-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL01 04 1619103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst