Provider Demographics
NPI:1174092787
Name:TOOLE, ANTOINETTE ELIZABETH (MA, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:ELIZABETH
Last Name:TOOLE
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:MISS
Other - First Name:ANTOINETTE
Other - Middle Name:ELIZABETH
Other - Last Name:RANJBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA ABA
Mailing Address - Street 1:6010 RYAN LN
Mailing Address - Street 2:
Mailing Address - City:STEWARTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17363-7339
Mailing Address - Country:US
Mailing Address - Phone:443-322-4344
Mailing Address - Fax:
Practice Address - Street 1:6010 RYAN LN
Practice Address - Street 2:
Practice Address - City:STEWARTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17363-7339
Practice Address - Country:US
Practice Address - Phone:443-322-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA525103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst