Provider Demographics
NPI:1225373921
Name:FELDER, ESTHER (BCBA)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:FELDER
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 1:310 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3351
Mailing Address - Country:US
Mailing Address - Phone:732-367-0019
Mailing Address - Fax:732-367-0019
Practice Address - Street 1:310 2ND ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3351
Practice Address - Country:US
Practice Address - Phone:732-367-0019
Practice Address - Fax:732-367-0019
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-12559103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst