Provider Demographics
NPI:1447747605
Name:MURRAY, ANNABELLE SMITH (BCBA)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:SMITH
Last Name:MURRAY
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 1:28 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2323
Mailing Address - Country:US
Mailing Address - Phone:973-420-8937
Mailing Address - Fax:
Practice Address - Street 1:779 GORNIK DR
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-1634
Practice Address - Country:US
Practice Address - Phone:973-420-8937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-05-2368103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst