Provider Demographics
NPI:1841774692
Name:FEDE, TONI ANNE (MA, BCBA, LBA (CT))
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:ANNE
Last Name:FEDE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA (CT)
Other - Prefix:MRS
Other - First Name:TONIANNE
Other - Middle Name:GIUNTA
Other - Last Name:FEDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, BCBA, LBA (CT)
Mailing Address - Street 1:220 S HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-4015
Mailing Address - Country:US
Mailing Address - Phone:908-565-3731
Mailing Address - Fax:
Practice Address - Street 1:220 S HILL RD
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-4015
Practice Address - Country:US
Practice Address - Phone:908-565-3731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-13-13457103K00000X
CT168103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty