Provider Demographics
NPI:1457708026
Name:CONSER, ANGELA (BCBA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CONSER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 GRAVEL PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2364
Mailing Address - Country:US
Mailing Address - Phone:215-888-8284
Mailing Address - Fax:
Practice Address - Street 1:1000 GRAVEL PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-2364
Practice Address - Country:US
Practice Address - Phone:215-888-8284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002723103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst