Provider Demographics
NPI:1154894350
Name:USHER, MARY (MA,BCBA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:USHER
Suffix:
Gender:F
Credentials:MA,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-1174
Mailing Address - Country:US
Mailing Address - Phone:856-473-5226
Mailing Address - Fax:
Practice Address - Street 1:321 LOCUST ST
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-1174
Practice Address - Country:US
Practice Address - Phone:856-473-5226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-34302103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst