Provider Demographics
NPI:1215413141
Name:DARBY, NELUNGWE CHUUNGA (BCBA)
Entity type:Individual
Prefix:
First Name:NELUNGWE
Middle Name:CHUUNGA
Last Name:DARBY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2925
Mailing Address - Country:US
Mailing Address - Phone:309-310-2448
Mailing Address - Fax:
Practice Address - Street 1:3209 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2925
Practice Address - Country:US
Practice Address - Phone:309-310-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018012755103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst