Individual
DYSHEA UPSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA 1-19-37422
Contact information
Practice address
190 N EVERGREEN AVE STE 205, WOODBURY, NJ 08096-1862
(856) 831-6646
Mailing address
921 GRENVILLE DR, BLACKWOOD, NJ 08012-1343
(856) 831-6646
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37422
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0713619
—
NJ
Enumeration date
09/06/2019
Last updated
03/07/2026
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