Provider Demographics
NPI:1639657711
Name:STEWART, RHONDA LESA (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LESA
Last Name:STEWART
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 SUNRISE HWY STE 106
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5352
Mailing Address - Country:US
Mailing Address - Phone:516-640-0798
Mailing Address - Fax:
Practice Address - Street 1:4250 SUNRISE HWY STE 106
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5352
Practice Address - Country:US
Practice Address - Phone:516-640-0798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001561-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst