Provider Demographics
NPI:1679202196
Name:DELLAPORTAS, JULIANNA (BCBA)
Entity Type:Individual
Prefix:MS
First Name:JULIANNA
Middle Name:
Last Name:DELLAPORTAS
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 1:37 COMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:HAZLET TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07734-3108
Mailing Address - Country:US
Mailing Address - Phone:732-703-1167
Mailing Address - Fax:
Practice Address - Street 1:78 JOHN MILLER WAY
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-6500
Practice Address - Country:US
Practice Address - Phone:855-500-3848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-22-59788103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst