Provider Demographics
NPI:1841624574
Name:SANK, MEGHAN JOAN (BCBA; LDTC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:JOAN
Last Name:SANK
Suffix:
Gender:F
Credentials:BCBA; LDTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 BACK BROOK RD
Mailing Address - Street 2:
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-1301
Mailing Address - Country:US
Mailing Address - Phone:908-391-2311
Mailing Address - Fax:
Practice Address - Street 1:155 BACK BROOK RD
Practice Address - Street 2:
Practice Address - City:RINGOES
Practice Address - State:NJ
Practice Address - Zip Code:08551-1301
Practice Address - Country:US
Practice Address - Phone:908-391-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-09-5567103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst