Provider Demographics
NPI:1336600345
Name:WINGATE, BIANCA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:BIANCA
Middle Name:
Last Name:WINGATE
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 1:13 DARTMOUTH AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3420
Mailing Address - Country:US
Mailing Address - Phone:908-414-8522
Mailing Address - Fax:
Practice Address - Street 1:1071 VALLEY RD
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1523
Practice Address - Country:US
Practice Address - Phone:908-604-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst