Provider Demographics
NPI:1588274203
Name:OREGAN, LINDSEY NICOLE (BCBA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:NICOLE
Last Name:OREGAN
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 COLTS GAIT RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-5713
Mailing Address - Country:US
Mailing Address - Phone:856-230-9663
Mailing Address - Fax:
Practice Address - Street 1:1902 FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2007
Practice Address - Country:US
Practice Address - Phone:856-230-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12043520103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst