Provider Demographics
NPI:1780135046
Name:MALONE, DENISE BROWN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:BROWN
Last Name:MALONE
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 1:111 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2210
Mailing Address - Country:US
Mailing Address - Phone:973-890-2415
Mailing Address - Fax:
Practice Address - Street 1:111 2ND AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-2210
Practice Address - Country:US
Practice Address - Phone:973-890-2415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-10-7559103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst