Provider Demographics
NPI:1801661525
Name:SJAASTAD, EMILY (BCBA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SJAASTAD
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1463
Mailing Address - Country:US
Mailing Address - Phone:848-888-3204
Mailing Address - Fax:732-930-1821
Practice Address - Street 1:60 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1463
Practice Address - Country:US
Practice Address - Phone:848-888-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-23-69780103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst