Provider Demographics
NPI:1063751105
Name:GRAHAM, CARA MARIE (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MISS
Other - First Name:CARA
Other - Middle Name:MARIE
Other - Last Name:DOUGHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:7 BENSON ST
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-9772
Mailing Address - Country:US
Mailing Address - Phone:908-208-7614
Mailing Address - Fax:
Practice Address - Street 1:7 BENSON ST
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-9772
Practice Address - Country:US
Practice Address - Phone:908-208-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-09
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-12-12524103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst