Provider Demographics
NPI:1780471672
Name:THIGPEN, ANTONIA (RBT)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:THIGPEN
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 NEW JERSEY 34
Mailing Address - Street 2:BUILDING NO. 3, SUITE 301B
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719
Mailing Address - Country:US
Mailing Address - Phone:732-749-8317
Mailing Address - Fax:
Practice Address - Street 1:1800 NEW JERSEY 34
Practice Address - Street 2:BUILDING NO. 3, SUITE 301B
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-0771
Practice Address - Country:US
Practice Address - Phone:732-749-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25-424522106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician