Provider Demographics
NPI:1861211864
Name:OBRIEN, ROBERT B (BCBA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 HUTTON ST APT 45
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4237
Mailing Address - Country:US
Mailing Address - Phone:407-808-3008
Mailing Address - Fax:
Practice Address - Street 1:272 HUTTON ST APT 45
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4237
Practice Address - Country:US
Practice Address - Phone:407-808-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst