Provider Demographics
NPI:1093189938
Name:HOERNIG, JENNIFER LEANN (MSW, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEANN
Last Name:HOERNIG
Suffix:
Gender:F
Credentials:MSW, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 BERNADETTE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5007
Mailing Address - Country:US
Mailing Address - Phone:573-874-3777
Mailing Address - Fax:573-874-3880
Practice Address - Street 1:918 BERNADETTE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5007
Practice Address - Country:US
Practice Address - Phone:573-874-3777
Practice Address - Fax:573-874-3880
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015021450103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst