Provider Demographics
NPI:1942734793
Name:SCHAETZLE, JEFFREY (M ED, BCBA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:SCHAETZLE
Suffix:
Gender:M
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 EDGEMOOR RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3940
Mailing Address - Country:US
Mailing Address - Phone:215-620-2637
Mailing Address - Fax:
Practice Address - Street 1:15 CORPORATE PL S
Practice Address - Street 2:SUITE 333
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-6107
Practice Address - Country:US
Practice Address - Phone:732-770-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-17-25744103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst