Provider Demographics
NPI:1053841049
Name:SAXON, JILL LAURIE (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:LAURIE
Last Name:SAXON
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2332
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07091-2332
Mailing Address - Country:US
Mailing Address - Phone:908-913-0743
Mailing Address - Fax:
Practice Address - Street 1:524 DUDLEY CT
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3029
Practice Address - Country:US
Practice Address - Phone:908-913-0743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001127103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst