Provider Demographics
NPI:1255969663
Name:VOSS, STEPHANIE (BCBA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:VOSS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:KIMMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:542 AMHERST ST STE B
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1016
Mailing Address - Country:US
Mailing Address - Phone:909-362-1447
Mailing Address - Fax:
Practice Address - Street 1:500 DELAWARE AVE STE 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1490
Practice Address - Country:US
Practice Address - Phone:909-362-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-46327103K00000X
CORBT.17.41116106S00000X
DE1-20-46327103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-20-46327OtherBCBA