Jacquelin Ann Hickey, BCBA

Individual provider Active NPI Behavior Analyst · Keyport, NJ

NPI 1528296597 · NPPES record last updated Jun 29, 2009

Key facts

NPI
1528296597
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
BCBA 1-03-1113 (NY)
Practice address
37 Osborn St
Keyport, NJ 07735-1514
Phone
(732) 264-1947
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BCBA 1-03-1113 NY Yes

Addresses

Primary practice location

37 Osborn St
Keyport, NJ 07735-1514

Mailing address

37 Osborn St
Keyport, NJ 07735-1514
Phone (732) 264-1947

Other providers in Keyport, NJ

All providers in Keyport, NJ · Behavior Analyst in New Jersey

Sources for this page

Verify at the official NPI Registry.