Provider Demographics
NPI:1699078709
Name:FARAHER, ANNE E (BCBA)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:FARAHER
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 1:177 IRVINGTON AVE APT 1D
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2231
Mailing Address - Country:US
Mailing Address - Phone:856-616-9442
Mailing Address - Fax:
Practice Address - Street 1:177 IRVINGTON AVE APT 1D
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2231
Practice Address - Country:US
Practice Address - Phone:856-616-9442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-07-3413103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst