Provider Demographics
NPI:1760990287
Name:PREBLE, CHRISTINE (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:PREBLE
Suffix:
Gender:F
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 1:6645 STATE ROUTE 291
Mailing Address - Street 2:
Mailing Address - City:MARCY
Mailing Address - State:NY
Mailing Address - Zip Code:13403-3102
Mailing Address - Country:US
Mailing Address - Phone:315-269-2876
Mailing Address - Fax:
Practice Address - Street 1:64 COUNTY ROUTE 5A
Practice Address - Street 2:
Practice Address - City:NEW LEBANON
Practice Address - State:NY
Practice Address - Zip Code:12125
Practice Address - Country:US
Practice Address - Phone:315-269-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst