Provider Demographics
NPI:1710377288
Name:WUNDER, AMBER (BCBA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:WUNDER
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 1:1044 RUNAWAY DR
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1649
Mailing Address - Country:US
Mailing Address - Phone:267-281-4423
Mailing Address - Fax:877-872-8503
Practice Address - Street 1:1044 RUNAWAY DR
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073
Practice Address - Country:US
Practice Address - Phone:267-281-4423
Practice Address - Fax:877-872-8503
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-14-9564103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst