Provider Demographics
NPI:1447137476
Name:BRUCKLER, AMY LYNN (BCBA, LBS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:BRUCKLER
Suffix:
Gender:F
Credentials:BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6522 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8437
Mailing Address - Country:US
Mailing Address - Phone:570-881-3826
Mailing Address - Fax:
Practice Address - Street 1:6522 PIONEER DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8437
Practice Address - Country:US
Practice Address - Phone:570-881-3826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-25-81124103K00000X
PABH006927106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst