Provider Demographics
NPI:1053801746
Name:JEUDY, DANIELLE S (PHD, BCBA-D, LBA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:S
Last Name:JEUDY
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 HIGH ST UNIT 1432
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4565
Mailing Address - Country:US
Mailing Address - Phone:908-487-4545
Mailing Address - Fax:
Practice Address - Street 1:427 HIGH ST UNIT 1432
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4565
Practice Address - Country:US
Practice Address - Phone:908-487-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-18-29545103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst