Provider Demographics
NPI:1801155171
Name:WAGNER CAYIR, TAMMY (BCBA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:WAGNER CAYIR
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 1:53 BRANFORD RD
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1349
Mailing Address - Country:US
Mailing Address - Phone:862-812-7533
Mailing Address - Fax:
Practice Address - Street 1:53 BRANFORD RD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1349
Practice Address - Country:US
Practice Address - Phone:862-812-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1 12 10519103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst