Provider Demographics
NPI:1437986734
Name:GREENSPAN, DREW (BCBA)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:GREENSPAN
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 1:37 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1047
Mailing Address - Country:US
Mailing Address - Phone:212-513-5144
Mailing Address - Fax:
Practice Address - Street 1:37 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1047
Practice Address - Country:US
Practice Address - Phone:212-513-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-24-74780103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst