Provider Demographics
NPI:1871830273
Name:RUSH, MAURA PATRICE (SPEC ED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:PATRICE
Last Name:RUSH
Suffix:
Gender:F
Credentials:SPEC ED, BCBA
Other - Prefix:MRS
Other - First Name:MAURA
Other - Middle Name:PATRICE
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SPEC ED, BCBA
Mailing Address - Street 1:3 HIGH HEDGES CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1409
Mailing Address - Country:US
Mailing Address - Phone:516-695-7741
Mailing Address - Fax:
Practice Address - Street 1:3 HIGH HEDGES CT
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1409
Practice Address - Country:US
Practice Address - Phone:516-695-7741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst