Provider Demographics
NPI:1790957389
Name:CINOTTI-ROHR, CANDICE (BCBA)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:CINOTTI-ROHR
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:PO BOX 1009
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-1009
Mailing Address - Country:US
Mailing Address - Phone:201-446-4744
Mailing Address - Fax:
Practice Address - Street 1:4 WOODLAND ROAD
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645
Practice Address - Country:US
Practice Address - Phone:201-446-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJBCBA 1052173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional