Provider Demographics
NPI:1669913265
Name:DUFNER, DIANA (BCBA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:DUFNER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MANALAPAN RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1658
Mailing Address - Country:US
Mailing Address - Phone:908-217-9726
Mailing Address - Fax:
Practice Address - Street 1:23 MANALAPAN RD
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1658
Practice Address - Country:US
Practice Address - Phone:908-217-9726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NJ1-15-19410103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst