Provider Demographics
NPI:1225821671
Name:GANCARZ, AGNIESZKA A (MS ABA, BCBA, LBS)
Entity type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:A
Last Name:GANCARZ
Suffix:
Gender:F
Credentials:MS ABA, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WESTTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4941
Mailing Address - Country:US
Mailing Address - Phone:484-340-6668
Mailing Address - Fax:
Practice Address - Street 1:5 GREAT VALLEY PKWY STE 270
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1426
Practice Address - Country:US
Practice Address - Phone:484-757-5538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-22-57835103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst