Provider Demographics
NPI:1073016572
Name:COLE-WARRINER, JENNIFER LYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:COLE-WARRINER
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 1:386 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:NY
Mailing Address - Zip Code:13658-3175
Mailing Address - Country:US
Mailing Address - Phone:315-869-8562
Mailing Address - Fax:
Practice Address - Street 1:386 MURPHY RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:NY
Practice Address - Zip Code:13658-3175
Practice Address - Country:US
Practice Address - Phone:315-869-8562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst