Provider Demographics
NPI:1063813723
Name:GABLE, AMY (MED, BCBA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GABLE
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Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 NAZARETH PIKE
Mailing Address - Street 2:TROLLEY STATION MALL
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9080
Mailing Address - Country:US
Mailing Address - Phone:610-365-8373
Mailing Address - Fax:610-365-2522
Practice Address - Street 1:224 NAZARETH PIKE
Practice Address - Street 2:TROLLEY STATION MALL
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9080
Practice Address - Country:US
Practice Address - Phone:610-365-8373
Practice Address - Fax:610-365-2522
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PABH000126103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst