Provider Demographics
NPI:1659832046
Name:GUTH, AMELIA (BCBA)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:GUTH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LOETSCHER PL APT 202
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5958
Mailing Address - Country:US
Mailing Address - Phone:201-987-6139
Mailing Address - Fax:
Practice Address - Street 1:201 LOETSCHER PL APT 202
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5958
Practice Address - Country:US
Practice Address - Phone:201-987-6139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst