Provider Demographics
NPI:1487333597
Name:FURLONG, HEATHER (BCBA)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:FURLONG
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 1:21 PONDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-2652
Mailing Address - Country:US
Mailing Address - Phone:203-648-7328
Mailing Address - Fax:
Practice Address - Street 1:21 PONDFIELD RD
Practice Address - Street 2:
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812-2652
Practice Address - Country:US
Practice Address - Phone:203-648-7328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12257493103K00000X
CT103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst